Pediatric thoracic outlet syndrome: a systematic review with metadata
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In brief
In brief
This systematic review of 356 pediatric TOS cases reveals that children present with higher rates of vascular TOS compared to adults, with neurogenic TOS being most common (56.5%). Sports-related activities were the primary risk factor, and supraclavicular surgical approach was the preferred treatment method.
- Thoracic outlet syndrome in pediatrics is underrecognized but occurs more commonly than previously thought, especially in active adolescents.
- Pediatric TOS shows higher rates of vascular involvement compared to adults, requiring different diagnostic and treatment considerations.
- Sports-related activities are the primary risk factor for pediatric TOS, present in 54% of cases in this systematic review.
- Supraclavicular surgical approach is the preferred treatment method for pediatric TOS cases requiring operative intervention.
- Female adolescents represent nearly two-thirds of pediatric TOS cases, with neurogenic TOS being the most common subtype (56.5%).
Written by the GCMD Library team from the article.
Abstract
Introduction
Thoracic outlet syndrome (TOS) typically considered a condition of the adult population; it is often disregarded in children and adolescents due to its limited recognition within the pediatrics. The current study aims to systematically review and provide insights into TOS among pediatric patients.
Methods
PubMed, Scopus, Web of Science, and Google Scholar databases were thoroughly searched for English language studies published until March 15th, 2024. The study included those articles focusing on pediatric or adolescent individuals diagnosed with TOS. Data collected from studies encompassed date of publication, number of participants or reported cases, age (years), gender of participants, type of TOS, affected side, type of treatment, surgical approach, bony abnormality, duration of symptoms (months), outcome, and follow-up time duration (months).
Results
The current study comprised 33 articles, 21 of which were case reports, 10 of which were case series, and the remaining were cohort studies. In this study, 356 patients were included. Females constituted 234 (65.73%) of the patient population. Among TOS types, neurogenic TOS was found among 201 (56.5%) patients. Sporting-related activity or physical activity was present in 193 (54%) patients, followed by a history of trauma in 27 (7%) patients.
Conclusions
Pediatric patients exhibited a higher percentage of vascular TOS than their adult counterparts, with the supraclavicular approach emerging as the preferred treatment method. Sports-related activities were identified as the primary risk factor associated with pediatric TOS.