Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a constellation of symptoms caused by the compression of neurovascular structures at the superior aperture of the thorax, properly referred to as the thoracic inlet. However, there is no consistent clinical presentation or definition. Based on a comprehensive literature review, this article presents the etiology, epidemiology, and clinical diagnostics of TOS, as well as the possibilities and outcomes of surgical treatment. The diagnosis and treatment are contentious, and some even question the existence of TOS. Its symptoms are often confused with those of distal compression neuropathies or cervical radiculopathies. The various surgical approaches for this syndrome are evaluated according to their ability to facilitate wide exposure, their potential morbidity, and their beneficial results. Most patients suffering from any form of TOS can benefit from surgical treatment. The duration of symptoms, socioeconomic factors and most notably, a stringent diagnostic workup and an adequate operative approach are important.