Dorn Patrick, Zehnder Adrian, Kocher Gregor J
Klinik für Thoraxchirurgie, Inselspital, Universitätsspital Bern, Bern.
Praxis (Bern 1994). 2021;110(7):391-396. doi: 10.1024/1661-8157/a003660.
Thoracic Outlet Syndrome: Rare, Often Missed or Over-Diagnosed? The thoracic outlet syndrome (TOS) presents with various symptoms caused by compression of the neurovascular bundle in the region of the upper thoracic aperture. Since the pathogenesis also determines the therapy of TOS, the classification according to the affected structure into neurogenic, venous and arterial TOS (nTOS, vTOS and aTOS) is useful. However, mixed forms are often to be assumed, which are then usually also classified under the term 'non-specific or disputed TOS' in the group of nTOS. In the absence of a gold standard diagnostic test, accurate history taking and clinical examination continue to be of great importance. Diagnostic experience and therapeutic advances have led to hopeful possibilities in the challenging management of this condition.
罕见、常被漏诊或过度诊断?胸廓出口综合征(TOS)表现为上胸廓入口区域神经血管束受压引起的各种症状。由于发病机制也决定了TOS的治疗方法,根据受累结构将其分为神经源性、静脉性和动脉性TOS(nTOS、vTOS和aTOS)是有用的。然而,通常存在混合形式,这些混合形式通常也归类于nTOS组中的“非特异性或争议性TOS”。在缺乏金标准诊断测试的情况下,准确的病史采集和临床检查仍然非常重要。诊断经验和治疗进展为这种具有挑战性的疾病管理带来了充满希望的可能性。