Descriptive Anatomy of the Interscalene Triangle and the Costoclavicular Space and Their Relationship to Thoracic Outlet Syndrome: A Study of 60 Cadavers

Dahlstrom, Kelly; Olinger, Anthony

doi:10.1016/j.jmpt.2012.04.017

Cited by 31 publications

(32 citation statements)

References 17 publications

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“…TOS is a classical compression result with three specific levels which are the interscalene triangle, the costoclavicular space and the coracopectoral tunnel [ 8 ]-[ 10 ]. Given that TOS after the Nuss procedure is extremely unusual, and the multifactorial issues which has been attributed to TOS, a study for TOS should include these multifactorial issues.…”

Section: Discussionmentioning

confidence: 99%

A study about the costoclavicular space in patients with pectus excavatum

Kim

Park

et al. 2014

J Cardiothorac Surg

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BackgroundThe aim of the present study is to investigate the costoclavicular space in patients with pectus excavatum.Materials and methodsBetween April and November 2011, consecutive 50 patients with pectus excavatum and consecutive 50 patients without pectus excavatum were included into the present study. The costoclavicular measurements (the shortest distance, the crossing angle) were measured for the costoclavicular investigation.ResultsFirstly, there were no significant differences of the costoclavicular measurements in each and between symmetric and asymmetric subgroup, and in the overall, bilaterally. The shortest distance had a significant positive correlation with BMI (right p = 0.001, left p = 0.032) and a significant negative correlation with the crossing angle (right p = 0.013, left p = 0.001). Secondly, in the control group, the shortest distance had significant positive correlations with body weight and BMI (Body weight right p = 0.001, left p < 0.001; BMI right p = 0.001, left p < 0.001), and significant negative correlations with the crossing angles (right p = 0.002, left p < 0.001) and the sternal angle (right p = 0.032, left p = 0.017). Thirdly, the control group had the significant longer shortest distance than the pectus excavatum group (right p <0.001, left p <0.001). Fourthly, a decrease of the shortest distance (right p <0.001, left p <0.001), an increase of the crossing angle (right p < 0.001, left p < 0.001) and the sternal angle (p <0.001), and also a decrease of the Haller index (p <0.001) was found postoperatively.ConclusionPatients with pectus excavatum originally have narrower costoclavicular spaces than the normal control group, and the postoperative costoclavicular space are much narrower also.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0189-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A study about the costoclavicular space in patients with pectus excavatum

Kim

Park

et al. 2014

J Cardiothorac Surg

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“…Neurogenic TOS cases can also be diagnosed by Duplex ultrasonography 26,27 . In cadaver studies, the mean interscalene base width and mean costoclavicular space have been reported to be 10.7 mm and 13.5 mm, respectively 28 . The mean costoclavicular space measured by CT was 12.5 mm 29 .…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of TOS is controversial 44,45 , and no speci c set of diagnostic criteria has yet been established 48 21,22 . The measures assessed included blood ow disruption, low blood ow, and accelerated blood ow in the subclavian artery demonstrated by Doppler sonography, the scalene interval width between the anterior and middle interscalene muscles (interscalene base) 28 , and the costoclavicular space demonstrated by Duplex ultrasonography 26,27 in a resting position with the shoulder in abduction and in the external rotation (ABER) position sitting on a chair (Fig. 5) by a medical technologist (T.K.).…”

Section: Diagnosismentioning

confidence: 99%

Arthroscopy-assisted First Rib Resection and Brachial Plexus Neurolysis for Thoracic Outlet Syndrome

Satake

Honma

Nito

et al. 2021

Preprint

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The present study included 27 consecutive patients (30 limbs) undergoing arthroscopy-assisted transaxillary first rib resection and brachial plexus neurolysis for thoracic outlet syndrome (TOS). To improve visualization, we changed the intraoperative limb position in three stages. We assessed the intraoperative parameters, including the scalene interval width between the anterior and middle interscalene muscles (interscalene base), blood loss, operation time, preoperative and postoperative QuickDASH, patient satisfaction, and complications. The mean intraoperatively measured interscalene base width was 6.2 mm. Appropriate visualization could be obtained at zero-position in the late phase. Intraoperative blood loss and operation time were significantly less in the late phase (p < 0.001). The QuickDASH score was significantly improved (42 before surgery vs. 9 at final follow-up, p < 0.001), especially in athletes relative to non-athletes (0.2 vs 14, p < 0.001). The outcome was excellent in 43.3% of cases, good in 43.3%, fair in 13.3%, and poor in none. The present approach achieved complete relief in 43% of cases overall (91% in athletes and 16% in non-athletes). Pneumothorax was present at the early phase in 3.3%. There were no other complications and no recurrences. Arthroscopic surgery is useful for TOS, especially in athletes.

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“…(Hooper et al, 2010;Atasoy, 1996;Demondion et al, 2006;Jordan et al, 2013). The interscalene triangle the most medial of these spaces is bordered anteriorly by the posterior edge of the anterior scalene muscle, posteriorly by the anterior portion of the middle scalene muscle, and inferiorly by the superior aspect of the first rib, between the insertion sites for the anterior and middle scalene muscles ( Dahlstrom and Olinger, 2012).The anterior rami of the third, fourth, and fifth cervical spinal nerves and the superior, middle and inferior trunks of the brachial plexus and subclavian artery are located within the interscalene triangle. Several types of bony, fibrous and muscular abnormalities make this site susceptible to neurogenic compression (Hooper et al, 2010;Roos, 1976).…”

Section: Introductionmentioning

confidence: 99%

Cadaveric Measurement and Analysis of Interscalene Triangle and Costo-Clavicular Spaces in Relation to Thoracic Outlet Syndrome

Chaudhury

Ghosh

2020

Rev Arg de Anat Clin

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Objectives: Thoracic outlet syndrome (TOS) is an upper extremity disorder resulting from compression of brachial plexus structures and subclavian vessels within thoracic outlet region at any of the three primary sites- interscalene triangle, costoclavicular space and retro-pectoralis minor space. This study focused on detailed anatomic exploration and measurement of normal anatomic variability within interscalene triangle and costoclavicular space. Material and Method: We examined 49 cadavers (22 male and 27 female) and dissected both sides to explore and examine 98 dissected areas. We measured the base width, height, angle within interscalene triangle and the vertical distance within costoclavicular space. We also calculated the area of interscalene triangle. Results: The mean values of base width, height, interscalene angulation of interscalene triangle and height of costoclavular space was 10.18±4.31 mm, 45.19±0.07mm, 10.85±0.06 degrees and 10.22±0.07 mm respectively. The mean area of interscalene triangle was 214.82±5.22sqmm. Conclusion: We have found clinically significant differences between the interscalene and costiclavicular space vertical heights; the height of costoclavicular space was clinically significantly lower than the interscalene space (p< 0.001). No clinical significant difference was found between male and female measurements. These ranges of dataset could be useful for planning treatment approaches in TOS.

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Descriptive Anatomy of the Interscalene Triangle and the Costoclavicular Space and Their Relationship to Thoracic Outlet Syndrome: A Study of 60 Cadavers

Cited by 31 publications

References 17 publications

A study about the costoclavicular space in patients with pectus excavatum

A study about the costoclavicular space in patients with pectus excavatum

Arthroscopy-assisted First Rib Resection and Brachial Plexus Neurolysis for Thoracic Outlet Syndrome

Cadaveric Measurement and Analysis of Interscalene Triangle and Costo-Clavicular Spaces in Relation to Thoracic Outlet Syndrome

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