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Thoracic outlet syndromes (TOS)

Sist revidert:
Sist revidert av:
Definisjon:
En gruppe etiologisk og klinisk distinkte forstyrrelser som skyldes kompresjon av en eller flere nevrovaskulære elementer idet de passerer ut av thoraxhulen
Forekomst:
Sjelden, men er sannsynligvis underdiagnostisert
Symptomer:
Vanlige symptomer er smerter, nummenhet, parestesier, svekket kraft og tyngdefølelse i den involverte overekstremiteten
Funn:
Mulige kliniske funn kan være nakkesmerter som forverres ved bruk av elevert arm, parestesier tilsvarende segmentene C8-Th1, ømhet over plexus brachialis supraklavikulært, positiv Roos' test
Diagnostikk:
Bildediagnostikk er ikke pålitelig. Elektrofysiologiske undersøkelser kan være nyttige
Behandling:
Konservativ behandling med øvelser hos fysioterapeut anbefales primært og angis å gi gode resultater hos 80%. Kirurgi gir dårlige resultater
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  2. Kuhn JE, Lebus V GF, Bible JE. Thoracic outlet syndrome. J Am Acad Orthop Surg. 2015 Apr;23(4):222-32. doi: 10.5435/JAAOS-D-13-00215 DOI  
  3. Rosenbaum DA. Thoracic Outlet Syndrome. Medscape, last updated Jan 10, 2019. emedicine.medscape.com  
  4. Hong J, Pisapia JM, Ali ZS, et al. Long-term outcomes after surgical treatment of pediatric neurogenic thoracic outlet syndrome. J Neurosurg Pediatr 2018; 21:54. PubMed  
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  7. Ferrante MA, Ferrante ND. The thoracic outlet syndromes: Part 2. The arterial, venous, neurovascular, and disputed thoracic outlet syndromes. Muscle Nerve. 2017 Oct;56(4):663-673 . pmid:28006856. PubMed  
  8. Orlando MS, Likes KC, Mirza S, et al. A decade of excellent outcomes after surgical intervention in 538 patients with thoracic outlet syndrome. J Am Coll Surg 2015; 220:934. PMID: 25840533 PubMed  
  9. Sanders RJ, Rao NM. The forgotten pectoralis minor syndrome: 100 operations for pectoralis minor syndrome alone or accompanied by neurogenic thoracic outlet syndrome. Annals of vascular surgery 2010; 6: 701-8. PubMed  
  10. Urschel HC, Kourlis H. Thoracic outlet syndrome: a 50-year experience at Baylor University Medical Center. Proc (Bayl Univ Med Cent). 2007;20:125-135. PubMed  
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  12. Stewman C, Vitanzo PC Jr, Harwood MI. Neurologic thoracic outlet syndrome: summarizing a complex history and evolution. Curr Sports Med Rep. 2014;13:100-106. PubMed  
  13. Machanic BI, Sanders RJ. Medial antebrachial cutaneous nerve measurements to diagnose neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2008;22:248-254. PubMed  
  14. Povlsen B, Hansson T, Povlsen SD. Treatment for thoracic outlet syndrome. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD007218. DOI: 10.1002/14651858.CD007218.pub3. DOI  
  15. Lo CNC, Bukry SA, Alsuleman S, et al. Systematic review: the effectiveness of physical treatments on thoracic outlet syndrome in reducing clinical symptoms. Hong Kong Physiother J. 2011;29:53-63. PubMed  
  16. Stewman C, Vitanzo PC, Harwood MI, Beredjiklian PK. Thoracic outlet syndrome. BestPractice, last updated Mar 2018.
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  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Pål Kristensen, spesialist i allmennmedisin, Ranheim legesenter, Trondheim