Which of the following is not a complication of surgery for thoracic outlet syndrome.
Correct Answer: Lymphocutaneous fistula
Description: Surgical treatment in thoracic outlet syndrome has been known to have devastating complications, especially brachial plexopathy (eg, injury to the long thoracic nerve with scapular winging). Conservative treatment appears to be the most universally accepted approach, with even surgeons recommending a prolonged trial before any operative procedure
Complications of surgical tit of thoracic outlet syndrome
Brachial plexus injury
Injury to long thoracic nerve leading to winging of the scapula
Homer's syndrome
Vascular injuries — subclavian artery , subclavian vein
Air embolus as a result of subclavian vein injury
Pneumothorax
Thoracic Outlet Syndrome
Thoracic outlet syndrome ( TOS ) refers to compression of the subclavian vessels and nerves of the brachial plexus in the region of the thoracic inlet. ( note that even though the actual site of pathology is the thoracic inlet the condition is called thoracic outlet syndrome )
These neurovascular structures of the upper extremity may be compressed by a variety of structures, such as
Bone- cervical rib, abnormal first rib, long transverse process of C7, osteoarthritis
Muscles- scalenus
Trauma- neck hematoma, bone dislocation, clavicular fracture
Fibrous bands- congenital or acquired
Neoplasms- Pancoast's tumor emedicine.com writes
The primary cause is believed to be mechanical or postural. Stress, depression, overuse, and habit all can lead to the forward head, droopy shoulder, and collapsed chest posture that allows the thoracic outlet to narrow and compress the neurovascular structures. Accessory ribs or fibrous bands when present, predispose the site to narrow and compression.
Management
Initial method of management is nonsurgical.
Physical and occupational therapy:
improvements in a postural sitting, standing, and sleeping positions are recommended, along with behavior modification at work.
muscle strengthening and stretching exercises
superficial or deep heat therapy
50 to 90% of patients can be treated with these nonsurgical measures.
Surgery
resection of the first rib, accessory rib or fibrous band, scalenectomy
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now