Clinical Importance of Thoracic Operculum Syndrome

Abstract

The Thoracic Outlet Syndrome (TOS) has been described as a spectrum of clinical conditions product of the dynamic compression of the brachial plexus and subclavian vessels in three distinct anatomical points on its route from the cervical region to the axillary: Interscalene compression, costoclavicular and less retropectoral. Thoracic Oulet Syndrome is a condition of complex diagnosis because of the wide spectrum of clinical manifestations presents and lack of diagnostic tests for confirmation, it is mainly based on the clinical judgment of the physician after careful analysis of the clinical history and examination physical. However, often the clinical study of patients is insufficient to determine the site and the structures involved in compression. CT angiography and magnetic resonance associated with postural maneuvers (Wright, Adson and Roos), can demonstrate the dynamic compression of the neurovascular structures important for proper management of patients with Thoracic Outlet Syndrome. Treatment is usually conservative with education, physical therapy and changes in daily physical activity; although, surgical management is controversial considerations, the results of surgical decompression depend on the type of TOS.