Neurogenic Thoracic Outlet and Pectoralis Minor Syndromes in Children. (July 2013)

• Record Type: Journal Article
• Authors: Sanders, Richard J.; Annest, Stephen J.; Goldson, Edward
• Is Part Of: Vascular & endovascular surgery. Volume 47:Number 5(2013)
• Page Start: 335
• Page End: 341
• Publication Date: 2013-07
• Subjects: neurogenic thoracic outlet syndrome -- neurogenic pectoralis minor syndrome -- scalenectomy -- first rib resection -- medial antebrachial cutaneous nerve measurement -- scalene muscle block -- pectoralis minor muscle block -- brachial plexus compression -- pectoralis minor tenotomy; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/1538574413481858
• Languages: English
• ISSNs: 1538-5744

Abstract

Brachial plexus compression (BPC) occurs above the clavicle as neurogenic thoracic outlet syndrome (NTOS) and below as neurogenic pectoralis minor syndrome (NPMS). It was recently noted that 75% of the adults seen for NTOS also had NPMS and in some this was the only diagnosis. This is also true in children but has not yet been reported. Because surgical treatment of NPMS is a minimum risk operation for pectoralis minor tenotomy (PMT), recognition of NPMS and distinguishing it from NTOS becomes important. In this study, 40 operations, 20 PMT and 20 NTOS procedures, were performed. Success rate for PMT was 85% and for thoracic outlet decompression was 70%. It was concluded that in children, as in adults, BPC is more often due to combined NTOS and NPMS. Surgical PMT should be considered first as the treatment of choice for children with NPMS. Thoracic outlet decompression is available if PMT is unsuccessful.