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The supraclavius muscle is a novel muscular anomaly observed in two cases of thoracic outlet syndrome

Published on Jun 1, 2015in Journal of Vascular Surgery Cases and Innovative Techniques
路 DOI :10.1016/j.jvsc.2015.02.001
Payam Salehi1
Estimated H-index: 1
(WashU: Washington University in St. Louis),
Wande B. Pratt17
Estimated H-index: 17
(WashU: Washington University in St. Louis)
+ 2 AuthorsRobert W. Thompson55
Estimated H-index: 55
(WashU: Washington University in St. Louis)
Abstract
Various anomalous muscles and fibrofascial structures have been described in relation to the anatomy of thoracic outlet syndrome. We describe two patients with a previously undescribed muscle anomaly, which originated laterally near the trapezius muscle, coursed across the supraclavicular space deep to the scalene fat pad, and attached obliquely to the superior undersurface of the medial clavicle, which we have termed the "supraclavius" muscle. The significance of the supraclavius muscle is unknown, but its occurrence in patients with thoracic outlet syndrome indicates that it can be associated with narrowing of the anatomic space adjacent to the neurovascular structures.
  • References (8)
  • Citations (1)
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References8
Newest
#1Richard J. Sanders (St Lukes Episcopal Hospital)H-Index: 2
Knowledge of anatomy is the key to understanding the thoracic outlet syndrome (TOS). By definition, TOS is hand and arm symptoms of pain, paresthesia, and weakness due to compression of the neurovascular bundle in the thoracic outlet area. While initially the scalene triangle was the focus of pathology in TOS, recent studies indicate that more than half of the patients thought to have TOS also have associated pectoralis minor compression, and in some patients this is the only diagnosis. Finally,...
2 CitationsSource
#1Jason H. Huang (HUP: Hospital of the University of Pennsylvania)H-Index: 24
#2Eric L. Zager (HUP: Hospital of the University of Pennsylvania)H-Index: 32
OBJECTIVE: Thotacic outlet Syndrome (TOS) one of the most controversial clinical entities in medicine. We-provide a review of this difficult-to-treat disorder, including a brief overview, clinical presentations, surgical anatomy, treatment options, and outcomes. METHODS: TOS represents a spectrum of disorders encompassing three elated syndromes: compression of the brachial plexus (neurogenic TOS), compression of the subclavian artery or vein (vascular TOS), and the nonspecific or disputed type o...
272 CitationsSource
Neurogenic thoracic outlet syndrome (TOS) occurs because there is insufficient space for the nervous structures. There is usually a congenital predisposition to develop TOS symptoms. An injury that may seem minor usually is superimposed on the congenital anomalies and compromises the space further. The symptom complexes that are recognized as TOS have been known for more than 100 years. They are variously overdiagnosed or underdiagnosed, depending on one鈥檚 perspective [1,2]. They are interesting...
59 CitationsSource
#1Darlene M. Redenbach (UBC: University of British Columbia)H-Index: 5
#2Bill Nelems (UBC: University of British Columbia)H-Index: 14
Objective: We have hypothesized that variations in fibrous, muscular and osseous structures with the potential to entrap the brachial plexus occur within the thoracic outlet of the normal population; and that these variations are different in pattern and frequency from those in patients presenting with thoracic outlet syndrome (TOS). Methods: Structural anomalies with potential for entrapping elements of the brachial plexus were examined following dissections of the posterior triangle of the nec...
33 CitationsSource
#1Walter G. Harry (UTMB: University of Texas Medical Branch)H-Index: 1
#2John D.C. Bennett (UTMB: University of Texas Medical Branch)H-Index: 1
Last. Somes C. Guha (UTMB: University of Texas Medical Branch)H-Index: 6
view all 3 authors...
Anatomical variations may be clinically significant, but many are inadequately described or quantified. Variations in neck anatomy are important to surgeons performing surgical procedures in this region. Thirty-two female and 19 male adult cadavers were studied. The commonly described anatomical relationship of the brachial plexus (BP) lying between the anterior scalene (AS) and middle scalene (MS) muscles was found in only 60%; of instances. Scalenus minimus was present in 46%; of instances (bi...
100 CitationsSource
#1Tatu Juvonen (University of Oulu)H-Index: 47
#2Jari Satta (University of Oulu)H-Index: 25
Last. Juha Nissinen (University of Oulu)H-Index: 8
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Abstract Background : Abnormal anatomy at the thoracic outlet is frequent in patients operated on for thoracic outlet syndrome (TOS). The present study was designed to find out the rate of thoracic outlet anomalies in the general population. Methods : Fifty cadavers representing a general population were subjected to a total of 98 meticulously performed cervical dissections to ascertain the frequency of congenital anomalies in the thoracocervicoaxillary region. Results : During the 98 cervical d...
76 CitationsSource
#1Raymond G. Makhoul (MCV: VCU Medical Center)H-Index: 18
#2Herbert I. Machleder (MCV: VCU Medical Center)H-Index: 1
Abstract Anatomic observations were made during 200 consecutive transaxillary surgical procedures performed in 175 patients because of unremitting signs and symptoms of nerve or vascular compression at the thoracic outlet. There were 160 cases of brachial plexus compression and 40 cases of arterial or venous occlusion. In 132 (66%) of these cases, single or multiple abnormalities were recognized that represented developmental variations previously described in anatomic dissections or in embryolo...
101 CitationsSource
Abstract Personal evaluation of more than 2,300 patients for possible thoracic outlet syndrome (TOS) and knowledge gained from 980 TOS operations in 766 patients (operative incidence of 33.7 per cent of the patients examined) have shown that most patients with TOS have anomalous fibrous muscular bands near the brachial plexus that predispose them to neurologic irritation or compression involving the plexus. Anatomic analysis during operations for TOS, plus cadaver dissections, have disclosed sev...
310 CitationsSource
Cited By1
Newest
#1Evan R. Brownie (WashU: Washington University in St. Louis)
#2Robert W. Thompson (WashU: Washington University in St. Louis)H-Index: 55
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