Thoracic outlet syndromes (T.O.S.) are uncommon and difficult
to manage. The objective of this article was to review the
author's experience with regard to its management.
All patients presenting with T.O.S. who were seen by the
author over 6 years period were studied. There were 21 cases of
T.O.S. The mean age of the group was 37.0 years (range 17-65
years). Majority were females (76.2%). The causative anomalies
were 17 cervical rib (80.9%), 3 fibrous bands (14.3%), one
hypoplastic first rib. Angiography was done selectively.
Twelve patients presented with neurological manifestations
(57.2%), 3 (14.3%) with arterial, 2 (9.5%) venous and 4 (19.0%)
with more than one structure compressed. Fifteen cases were
managed conservatively while 6 (2~.8%) patients underwent a
surgical decompression procedure via a supraclavicular route
solely. There was no mortality and no significant morbidity rates.
All patients (except one) in the surgical group did well in the
Surgical decompression of T.O.S. cases is recommended in all
patients with severe neurological symptoms and/or evidence of
vascular compression. Simple excision of the cervical rib and/or
a constricting fibrous band via a supraclavicular incision is
sufficient in most of the cases