Dunant J H
Vasa. 1994;23(3):189-94.
Under certain circumstances patients with a constitutional predisposition, mainly with atypical ligaments and bands or a cervical rib may develop a Thoracic Outlet Syndrome (TOS). TOS can be divided into three subgroups: arterial, venous and neurogenic. Most of our cases have neurogenic symptoms combined with signs of arterial compression. The complications of TOS are arterial and venous. "TOS" is a clinical diagnosis. A history of upper extremity paresthesia that is exacerbated by abduction is typical for TOS. Objective neurological findings are usually lacking. Positive provocative maneuvers are suggestive, but not necessarily conclusive of TOS. Operations for TOS should be considered only when the diagnosis is certain, when conservative treatment has failed and when operative decompression is the only solution. Three quarter of the patients referred to us have a very mild TOS or are eventually diagnosed with other conditions and are not operated upon. Transaxillary first rib resection is recommended. The results are excellent, provided the diagnosis is accurate, the indication strict and the operative technique meticulous. Severe complications are infrequent.
在某些情况下，具有体质易感性的患者，主要是具有非典型韧带和束带或存在颈肋时，可能会发展为胸廓出口综合征（TOS）。TOS可分为三个亚组：动脉型、静脉型和神经型。我们的大多数病例都有神经症状并伴有动脉受压体征。TOS的并发症有动脉性和静脉性的。“TOS”是一种临床诊断。上肢感觉异常病史在手臂外展时加重是TOS的典型表现。通常缺乏客观的神经学检查结果。阳性激发试验有提示作用，但不一定能确诊TOS。只有在诊断明确、保守治疗失败且手术减压是唯一解决办法时，才应考虑对TOS进行手术。转诊到我们这里的患者中有四分之三患有非常轻微的TOS，或最终被诊断为其他疾病，未接受手术治疗。建议行经腋路第一肋切除术。如果诊断准确、适应证严格且手术技术精细，结果会非常好。严重并发症并不常见。
