title: Neurogenic thoracic outlet and pectoralis minor syndromes in children.
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.
authors.affiliation: University of Colorado, Denver, CO 80220, USA. rsanders@ecentral.com
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Sanders
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Annest
authors.forename: Edward
authors.initials: E
authors.lastname: Goldson
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D019299:Decompression, Surgical / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects; D018579:Patient Selection; D010369:Pectoralis Muscles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery*; D058971:Tenotomy / Q000009:adverse effects; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: brachial plexus compression; first rib resection; medial antebrachial cutaneous nerve measurement; neurogenic pectoralis minor syndrome; neurogenic thoracic outlet syndrome; pectoralis minor muscle block; pectoralis minor tenotomy; scalene muscle block; scalenectomy