Ranney D
School of Anatomy, University of Waterloo, Ontario, Canada.
Clin Anat. 1996;9(1):50-2. doi: 10.1002/(SICI)1098-2353(1996)9:1<50::AID-CA10>3.0.CO;2-9.
The diagnosis of thoracic outlet syndrome (TOS) is intrinsically difficult, and the literature about it is full of confusing terminology. Symptoms may arise due to compression of neural and/or vascular elements in one or more of three different locations. A number of tests were developed during the early part of this century, and a variety of syndromes have been described that relate to these tests, all of which are now considered to be subtypes of the thoracic outlet syndrome. Yet anatomists and clinicians fail to agree on even the definition of the thoracic outlet. It is proposed that anatomists not use the term thoracic inlet as a synonym for the superior thoracic aperture, nor thoracic outlet for the inferior thoracic aperture. What many clinicians call the thoracic outlet should be called the scalene triangle by both anatomists and clinicians, divisible into a lower portion to be called the thoracic outlet (for subclavian vessels and nerve roots C.8 and T.1) and an upper portion, the cervical outlet (for nerve roots C.5, C.6, and normally C.7). What is currently called thoracic outlet syndrome should be renamed the cervicoaxillary syndrome (CAS), divisible into three subtypes: thoracic outlet, costoclavicular, and pectoralis minor syndromes. Compression of the upper roots of the brachial plexus between the anterior and middle scalene muscles should be recognized as cervical outlet syndrome, and all terms containing the word scalenus should be discarded.
胸廓出口综合征（TOS）的诊断本身就很困难，而且关于它的文献充斥着令人困惑的术语。症状可能是由于神经和/或血管成分在三个不同位置中的一个或多个位置受到压迫而产生的。在本世纪初开发了许多测试方法，并且描述了与这些测试相关的多种综合征，现在所有这些都被认为是胸廓出口综合征的亚型。然而，解剖学家和临床医生甚至在胸廓出口的定义上也未能达成一致。有人提议，解剖学家不应将胸廓入口用作胸廓上口的同义词，也不应将胸廓出口用作胸廓下口的同义词。许多临床医生所称的胸廓出口，解剖学家和临床医生都应称之为斜角肌三角，可分为下部，称为胸廓出口（用于锁骨下血管和颈8及胸1神经根）和上部，即颈部出口（用于颈5、颈6神经根，通常还有颈7神经根）。目前所称的胸廓出口综合征应重新命名为颈腋综合征（CAS），可分为三个亚型：胸廓出口型、肋锁型和胸小肌型综合征。臂丛神经上根在前斜角肌和中斜角肌之间受到的压迫应被视为颈部出口综合征，所有包含“斜角肌”一词的术语都应摒弃。
