| ABSTRACT Thoracic Outlet Syndrome (TOS) are constellation of symptoms caused by compression of the neurovascular bundle including the brachial plexus, the subclavian artery and the subclavian vein at the thoracic outlet region. The unique anatomy of the thoracic outlet??leads to a susceptibility for neurovascular compression of this area. ?It can be divided into neurogenic TOS, venus TOS, arterial TOS, which is depending on whether the brachial plexus or subclavian?vessel is involved. Neurogenic TOS is the most common type. TOS has varied manifestations and lacks of confirmatory testing, therefore, it still remians controversial. The diagnosis should be conbination with thorough history, physical examination and associated?supplementary examinations including imaging and electrophysiologic study. Also it can target the accurate site of compression. Conservative and surgical treatment can be choosed for TOS and the outcomes are generally good. Conservative management is the initial treatment strategy for neurogenic TOS. In cases of symptomatic vascular TOS and neurovascular TOS, which has been failed by conservative treatment, surgery should be considered more promptly. Early surgical treatment (<3 months) has better postoperative functional outcomes compared to late surgery (>6 months). Recently, minimally invasive surgery has been employed for treatment of TOS and it has a good early outcome. However, the long-term clinical effect needs to be further clarified. |
