Thoracic outlet syndrome

The thoracic outlet-syndrome (TOS) results from compression of the brachial plexus at the superior thoracic aperture. Sometimes it is accompanied by vascular symptoms. Every non typical peripheral compression syndrome, recurrent compression symptomatology or the presence of several irritable nerve segments should let TOS enter into the diagnostic considerations. Diagnosis is not simple and requires a synoptic approach using several investigations. Initial therapy is conservative. Surgical management implies good knowledge of anatomy and possible anomalies of the upper thoracic aperture.