Recurrent and Residual Neurogenic Thoracic Outlet Syndrome

Most often, recurrent neurogenic thoracic outlet syndrome (NTOS) is due to post-operative scar tissue growth surrounding the dissected brachial plexus causing re entrapment and compression of nerves, with restriction of nerve movement and function. Other etiologies to consider for return of symptoms include another contributory diagnosis outside of plexus entrapment, or inadequate decompression of nerves at initial procedure. Presenting complaints of recurrent NTOS are typical symptoms and findings of NTOS. Searching for potentially easily remedied causes, the clinician should investigate contribution of brachial plexus cord entrapment at the pectoralis minor muscle if that was not treated previously. Surgical decompression of the pectoralis minor muscle is a relatively risk free, outpatient procedure with potential for significant patient benefit.