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

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

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

No abstract available.
Thoracic Outlet Syndrome*

No abstract available.
Thoracic Outlet Syndrome*

No abstract available.
Hand* ; Thoracic Outlet Syndrome*

A number of patients with thoracic outlet syndrome experience intractable pain unresponsive to pharmacologic treatment. In this case, a brachia! plexus neurolysis was performed to address the patient's pain secondary to an enlarging left supraclavicular node. Guided under CT scan, 3 ml of 95% alcohol was injected in between the anterior and middle scalene muscles onto the trunks of the left brachia! plexus, affording immediate pain relief. Particular concerns of motor blockade, phrenic nerve palsy, stellate ganglion blockade, and bleeding did not occur. Therefore, brachia! plexus neurolysis can be safely done at a lower volume, without the above debilitating complications. It can be an option in relieving intractable upper extremity pain.
Brachial Plexus ; Thoracic Outlet Syndrome

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

OBJECTIVE: To evaluate the efficacy of scalene injection in patients with thoracic outlet syndrome. METHODS: We selected 142 patients diagnosed with thoracic outlet syndrome between January 2005 and October 2009. We performed a series of scalene injection with conservative treatment in all cases. Patients rated their pain degrees using a visual analogue scale. We also evaluated the time to return to everyday life and work, and patients' functional capacity. RESULTS: There were no complications or instances of inadvertent somatic or sympathetic ganglionic blockade after scalene injection. Overall, 111 patients (76.5%) experienced improved symptoms after the first set of scalene injection and 128 patients (88.2%) improved after scalene injection followed by conservative treatment. Of the 68 patients who returned to work during the study period, 54 returned within 1 week, and 62 within 2 weeks. Of those who returned to work, 61 reported nearly full functional capacity. We found that scalene injection was more effective in cases of thoracic outlet syndrome related to trauma than in those related to work-related repetitive stress. CONCLUSION: In patients with thoracic outlet syndrome, scalene injection effectively reduces pain. We recommend scalene injection as an adjunct to conservative treatment.
Ganglia, Sympathetic ; Humans ; Thoracic Outlet Syndrome