Thoracic Outlet Decompression 1 Mackinnon SE1 Yee A1 May 17, 2011Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.Neurological thoracic outlet 'inlet' syndrome (TOS) involves compression of the brachial plexus through the thoracic inlet. The neurologic symptoms of TOS can range from mild paresthesias and numbness in the upper extremity to intrinsic hand muscle atrophy. Thoracic outlet decompression entails decompressing the upper, middle, and lower trunks by dividing the anterior and middle scalene through a supraclavicular approach. Upon exposure, the platysma is divided and the supraclavicular nerves are protected. Upon approach, the omohyoid is divided. Prior to dividing the scalenes, the phrenic and long thoracic nerves are identified and protected. In this particular case, the platysma was scarce. A tourniquet is seen during orientation as an ulnar nerve transposition followed the thoracic outlet decompression in this patient.Keywords: supraclavicular exposurethoracic outlet syndromecompression neuropathybrachial plexusnerve decompression You must login to view the full article and extended video on this page. Standard Edition Table of Contents- Slow down- Frustration00:00:00 - Introduction00:00:10 - Orientation00:00:15 - Incision / Exposure and Identifying Supraclavicular Nerve Branches00:01:40 - Identification of the Supraclavicular Nerve Trunk00:02:15 - Identifying and Dividing the Omohyoid Muscle00:03:05 - Identification and Electrical Stimulation of the Phrenic Nerve00:03:40 - Identifying and Dividing the Anterior Scalene Muscle00:04:50 - Exposure of the Brachial Plexus00:05:15 - Identification of the Upper and Middle Trunk of the Brachial Plexus00:05:35 - Exposure of the Middle Scalene Muscle00:05:44 - Identifying and Dividing the Middle Scalene Muscle00:06:16 - Identification and Electrical Stimulation of the Long Thoracic Nerve00:06:50 - Identifying the Lower Trunk of the Brachial Plexus00:07:21 - Brachial Plexus and Adjacent Anatomical Structures Review00:07:51 - Re-examination for Further Nerve Compression by the Anterior and Middle Scalenes You must login to view the full article and extended video on this page. Leave a Comment Cancel replyYou must be logged in to post a comment.