González-Echeverria KE, Esqueda-Liquidano MA, Ariñez-Barahona E, Latorre-Dávila CA, Carrillo-Ruíz JD

Language: Spanish
References: 11
Page: 39-48
PDF size: 634.17 Kb.

ABSTRACT

Thoracic Outlet Syndrome (TOS) is a set of signs and secondary compression of vascular and nerve structures that make up the anatomical region called Thoracic Outlet (TO).1,2 The symptoms TO is defined as an area structural of transition between the root of the neck, chest apex and the beginning of the arm.3 Considering the complexity of the anatomical area has identified three areas in the neurovascular compression axis: scalene triangle, the costo-clavicular space and subcoracoide space; therefore, the clinical presentation depends on anatomical area which compresses the area TO and vascular or nervous structures affected.
Objective: 1) Identify and review the clinical, diagnosis and medical treatment - surgery, 2) Perform an anatomical dissection of the brachial plexus adequately exploring likely sites of chronic compression.
Material and Methods: Based on 2 female patients had different clinical and maneuver positive Adson diagnosed and surgically intervened in the General Hospital of Mexico; the average age was 28 years. The multidisciplinary team involved in the surgery included: neuro-anesthesiologist - thoracic surgeon and neurosurgeon. The micro surgical technique performed is also mentioned.
Results: Underwent decompression surgery consisted supraclavicular brachial plexus approach, have now evolved favorably, disappearing pain. In the long-term clinical follow-up have no paresis, paresthesia and dysesthesia, recovering their full sensory and motor functions.
Conclusions: First should be treated conservatively, if no good result opts for surgical treatment. Collisions indicated are two: transaxillary and supraclavicular. The latter is mostly recommended due to low morbidity and mortality according to studies. In case of recurrence new electromyography and nerve conduction velocity is requested.

REFERENCES

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3. Introducción a la cirugía de los nervios periféricos - Mariano Socolovsky, Mario Siqueira, Martijn Malessy.1era edición – 2013 – página 180 – Síndrome del desfiladero torácico – Capítulo 17.

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8. Neurocirugía aspectos clínicos y quirúrgicos. Dr. Armando J.A. Basso. 1era edición 2010 :1039

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