Cerivical rib syndrome, one of four common causes of thoracic outlet syndromes, have similar symptoms which accidentally discovered in simple x-ray and needs to be distinguished with other syndromes. Thoracic outlet syndromes are classified according to anatomical structures that causes symptoms; cervical rib syndrome, scalenus anticus syndrome, costoclavicular syndrome and hyperabduction syndrome. Various treatments for thoracic outlet syndromes have been introduced, such as; conservative care, excision of cervical rib and first rib and release of anterior scalenus muscle by supraclavicular approach and excision of cervical rib and first rib by axillary approach. We would like to report a case on a 16 years old girl and a 21 years old man who had cervical rib syndrome and treated successfully without excision of the first rib but excised cervical rib and released anterior scalenus muscle by supraclavicular approach.
Cervical Rib ; Cervical Rib Syndrome ; Muscles ; Ribs ; Thoracic Outlet Syndrome

Cervical rib is a normal asymptomatic congenital bone abnormality that occurs in 0.4% of the population; 70% of these cases are bilateral. Cervical ribs are found incidentally on routine radiographs, though sometimes patients complain of a hard or pulsatile neck mass in the supraclavicular area. Although most of these ribs produce no symptoms and need no therapy, a few cases are symptomatic and require treatment. Furthermore, a cervical rib can displace the great vessels superiorly and may cause iatrogenic hemorrhage during neck surgery. Thus, otorhinolaryngologists should be aware of the diagnosis and management of this condition in patients with a neck mass. Here, we report three cases of cervical rib and include a review of literature.
Cervical Rib ; Hemorrhage ; Humans ; Neck ; Ribs ; Thoracic Outlet Syndrome

Thoracic outlet syndrome is a collective term embracing previously described syndromes such as scalenus anticus, cervical rib, costoclavicular, hyperabduction and shoulder girdle compression syndromes. Its symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is the purpose of this paper to evaluate the results of experience in treating the patient with thoracie outlet syndrome by surgical means. In this study, 3 cases: cervical rib (1 case), excessive callus formation after clavicular fracture (1 case), and hyperabduction syndrome with combined scalenus anticus syndrome (1 case), which had developed thoracic outlet syndrome were treated at Severance Hospital and gratifying results were obtained.
Bony Callus ; Cervical Rib ; Humans ; Shoulder ; Thoracic Outlet Syndrome

Thoraic outlet syndrome is a collective term in which symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is the purpose of this paper to evaluate the results of treatment of patients with thoracic outlet syndrome by surgical methods. In this study, 7 cases, comprised of cervical rib (3 cases), excessive callus formation after clavicular fracture (2 cases), and scalenus anticus syndrome (2 cases), which had developed thoracic outlet syndrome were treated at Severance Hospital and good results were obtained.
Bony Callus ; Cervical Rib ; Humans ; Thoracic Outlet Syndrome

BACKGROUND: The literature on variations of rib is limited. Very little has been written in the radiological journal of this country on the subject. It seemed of interest to investigate the nature and incidence of congenital variations in a series of routine chest roentgenograms. The topic of rib variations has not been covered extensively in the radiological journals in Korea. This has presented an opportunity to investigate the nature, type, shape and incidences of congenital rib variations in normal Korean adults from a series of routine roentgenograms. METHODS: Chest radiographs of 5,000 adults (,) who visited our hospital for a routine check-up or for employment physical examinations from January 1996 to September 1998, were consecutively reviewed. The sex distribution consisted of 2,827 male males and 2,173 females (ratio of 1.3:1) with the age range between 19 and 65 years (mean age: 34.6 years). The chest PAs was were analyzed for the presence, type, location, and shape of the rib variations (.) From this data, and we the incidence of each type of variations was calculated. RESULTS: Seventy-six of the 5000 adults (1.52%), 63 male (2.23%) and 13 female (0.6%), showed 88 cases of rib variation (Table 1). Bifid rib (n=35) was the The most common variation was the bifid rib (n=35), followed by hypoplasia of the rib (n=22), flaring of the rib (n=18), bridging of the ribs (n=7), cervical ribs (n=3), and fusion of between ribs (n=3) (Table 2). (New paragraph)Bifid The bifid rib (Table 1) was found most frequent in the right fourth rib (12/35, 34.3%), followed by the left fifth rib (6/35, 17.1%) and right third rib (6/35, 17.1%). Hypoplasia of the rib was common in first rib (20/22, 90.9%). Flaring of the rib was common at fourth rib (8/18. 44.4%, right and left combined) (,) and bridging between ribs was common between first and second rib (3/7, 42.9%). CONCLUSION: The percentage of incidence of rib variations in adults was 1.52%. Bifid rib was the most common variation, followed by hypoplasia, flaring, bridging, cervical rib, and fusion of ribs(,) in decreasing order.
Adult ; Cervical Rib ; Employment ; Female ; Humans ; Incidence* ; Korea ; Male ; Physical Examination ; Radiography ; Radiography, Thoracic* ; Ribs* ; Sex Distribution ; Thorax*

A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.
Angiography ; Arm ; Cervical Rib ; Follow-Up Studies ; Muscles ; Pallor ; Ribs ; Subclavian Artery ; Thoracic Outlet Syndrome* ; Upper Extremity

Congenital high scapula, more commonly referred to as Sprengel's deformity, was first described by Eulenberg in 1863. Usually other congenital anomalies are associated such as absent or fused ribs, chest wall asymmetry, Klippel-Feil syndrome, cervical ribs, congenital scoliosis, cervical spina biffida was treated with the excision of the elongated acromion and the resection of prominent elongated acromion to be described is an extremely rare malformation. We experienced one case of congenital high scapula associated with anomaly of the acromion, which was treated with the excision of the elongated acromion and the resection of prominent supermedial border of the scapula for the purpose of the cosmetic and functional correction. After 1 year follow up, abduction was improved by only 10 degrees in the glenohumeral joint with the definite cosmetic improvement.
Acromion ; Cervical Rib ; Congenital Abnormalities ; Follow-Up Studies ; Klippel-Feil Syndrome ; Ribs ; Scapula ; Scoliosis ; Shoulder Joint ; Thoracic Wall

PURPOSE: We wanted to investigate the clinical features and treatment results of arterial type thoracic outlet syndrome (a-TOS). METHODS: We retrospectively reviewed the surgical treatments (n=9) of a-TOS for 6 patients (4 primary, 2 secondary, males: 100%, mean age: 39.6 years). For achieving thoracic outlet decompression, we performed cervical rib resection (n=6) and scalenectomy (n=7) through a supraclavicular incision. Among the primary TOS patients, 4 patients required subclavian artery (SCA) reconstruction. Arterial bypass were performed using saphenous vein grafts for 2 patients with secondary a-TOS. RESULTS: As an underlying cause of primary a-TOS, all the patients revealed bilateral cervical ribs whereas the secondary a-TOS were caused by malunion of clavicular fractures. All the patients presented with hand ischemia: resting pain in 4, cyanosis in 4, tingling sense in 4, pallor in 2 and finger tip gangrene in 2. After surgical treatment, the ischemic symptoms improved in all patients, but not to a satisfactory levels in the patients with distal arterial emboli. We experienced pneumothorax, transient phrenic nerve palsy and winged scapula as the operative complications. CONCLUSION: To achieve better treatment outcomes, we recommend early surgical treatment before the occurrence of distal arterial embolization even in the asymptomatic patients who reveal subclavian artery abnormalities. For surgical treatment of a-TOS, the supraclavicular approach combined with infraclavicular incisions offers good exposure for achieving thoracic outlet decompression and SCA reconstructions.
Cervical Rib ; Cyanosis ; Decompression ; Fingers ; Gangrene ; Hand ; Humans ; Ischemia ; Male ; Pallor ; Paralysis ; Phrenic Nerve ; Pneumothorax ; Retrospective Studies ; Saphenous Vein ; Scapula ; Subclavian Artery ; Thoracic Outlet Syndrome* ; Transplants