Abstract
Pectoralis minor syndrome (PMS) is a subset of neurogenic thoracic outlet syndrome (TOS) that can cause upper extremity symptoms of pain, paresthesia, and/or weakness due to compression of the neurovascular bundle by the pectoralis minor muscle (PM). The most distinguishing symptoms and signs of PMS include pain and/or tenderness in the subclavicular anterior chest wall and axilla. The clinical diagnosis of PMS can be confirmed by an improvement in symptoms and physical findings following a PM muscle block with local anesthetic. Treatment begins with PM stretching exercises. If this is insufficient, PM tenotomy (PMT) is a low risk operation, which can be performed as an outpatient. When PMS is the only diagnosis the success rate of PMT is 90 %, but when PMS is accompanied by nerve compression at the level of the scalene triangle the success rate of isolated PMT is only 35 %. PMS should also be considered in all patients with recurrent neurogenic TOS, as this condition has been found in a substantial proportion of such patients.
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References
Sanders RJ, Rao NM. The forgotten pectoralis minor syndrome: 100 operations for pectoralis minor syndrome alone or accompanied by neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2010;24:701–4.
Sanders RJ, Rao NM. Pectoralis minor obstruction of the axillary vein: report of six patients. J Vasc Surg. 2007;45:1206–11.
Sanders RJ, Hammond SL. Diagnosis of thoracic outlet syndrome. J Vasc Surg. 2007;46:601–4.
Wright IS. The neurovascular syndrome produced by hyperabduction of the arms: the immediate changes produced in 150 normal controls, and the effects on same persons of prolonged hyperabduction of the arms, as in sleeping, and in certain occupations. Am Heart J. 1945;29:1–19.
Lord Jr JW, Stone PW. Pectoralis minor tenotomy and anterior scalenotomy with special reference to the hyperabduction syndrome and “effort thrombosis” of the subclavian vein. Circulation. 1956;13:537–42.
d’Huart. A propos de six case de syndrome du scalene anterieur traites par scalenotomie et section du petit pectoral. Ann Chir 1964; 18:205–9.
McIntyre DI. Subcoracoid neurovascular entrapment. Clin Orthop Relat Res. 1975;108:27–30.
Stallworth JM, Quinn GJ, Aiken AF. Is first rib resection necessary for relief of thoracic outlet syndrome? Ann Surg. 1977;185:581–92.
Ambrad-Chalela E, Thomas GI, Johansen KH. Recurrent neurogenic thoracic outlet syndrome. Am J Surg. 2004;187:505–10.
Upton ARM, McComas AJ. The double crush in nerve-entrapment syndromes. Lancet. 1973;2:359–62.
Seror O. Medial antebrachial cutaneous nerve conduction study, a new tool to demonstrate mild lower brachial plexus lesions: a report of 16 cases. Clin Neurophysiol. 2004;115:2316–22.
Machanic BI, Sanders RJ. Medial antebrachial cutaneous nerve measurements to diagnose neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2008;22:248–54.
Sanders RJ. Recurrent neurogenic thoracic outlet syndrome stressing the importance of pectoralis minor syndrome. Vasc Endovascular Surg. 2011;45:33–8.
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© 2013 Springer-Verlag London
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Sanders, R.J. (2013). Pectoralis Minor Syndrome. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_15
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DOI: https://doi.org/10.1007/978-1-4471-4366-6_15
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