Pectoralis Minor Syndrome

In addition to the supraclavicular scalene triangle, brachial plexus compression in neurogenic thoracic outlet syndrome (TOS) may occur underneath the pectoralis minor muscle tendon at the level of the infraclavicular subcoracoid space. Nerve compression in the subcoracoid space can make a substantial contribution to symptoms in neurogenic TOS and untreated pectoralis minor compression may be an important factor in persistent or recurrent symptoms following operations for neurogenic TOS. Patients with neurogenic TOS may also have brachial plexus compression solely at the level of the pectoralis minor muscle, which can result in atypical chest pain. In patients properly selected based on physical examination, inclusion of pectoralis minor tenotomy provides a minimally-invasive surgical adjunct associated with low risk and a high likelihood of clinical success. Recognition and treatment of pectoralis minor syndrome has therefore become of increasing importance in the management of patients with neurogenic TOS.