A형 보툴리눔독소를 이용한 흉곽출구증후군의 치료 1례 -증례보고-
Type A Botulinum Toxin Therapy on Thoracic Outlet Syndrome -A case report-
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초록
The true neurogenic thoracic outlet syndrome (TOS), one type of the TOS, has vague and controversial clinical symptoms, so a variety of diseases can mimic the presentation of TOS, especially ulnar neuropathy or cervical root lesion. For most patients with TOS, common practice is to offer a course of conservative treatment, but its kinds are not enough and pain is too severe to do that in the chronic state. We experienced a case of true neurogenic thoracic outlet syndrome with distinctive clinical symptom and abnormal electrodiagnostic findings. The symptom was not controlled by conservative management including oral medication or physical therapy. So we injected type A botulinum toxin (BotoxⓇ) in the scalene and pectoralis minor muscles with ultrasonography guide. After 2 weeks, the pain decreased in visual analogue scale nine to four, and the compliance to physical therapy was improved. The result appeared to demonstrate that botulinum toxin injection may be helpful in controlling symptoms and making the patient adapt in physical therapy in the difficult case to management by any other methods.
Abstract
The true neurogenic thoracic outlet syndrome (TOS), one type of the TOS, has vague and controversial clinical symptoms, so a variety of diseases can mimic the presentation of TOS, especially ulnar neuropathy or cervical root lesion. For most patients with TOS, common practice is to offer a course of conservative treatment, but its kinds are not enough and pain is too severe to do that in the chronic state. We experienced a case of true neurogenic thoracic outlet syndrome with distinctive clinical symptom and abnormal electrodiagnostic findings. The symptom was not controlled by conservative management including oral medication or physical therapy. So we injected type A botulinum toxin (BotoxⓇ) in the scalene and pectoralis minor muscles with ultrasonography guide. After 2 weeks, the pain decreased in visual analogue scale nine to four, and the compliance to physical therapy was improved. The result appeared to demonstrate that botulinum toxin injection may be helpful in controlling symptoms and making the patient adapt in physical therapy in the difficult case to management by any other methods.
참고문헌 (10)
- Clagett O. T., "Research and prosearch", Thorac Cardiovasc Surg, 44, pp.153~166 (1962)
- Cuetter A. C., "The thoracic outlet syndrome: controversies, overdiagnosis, overtreatment, and recommendations for management", Muscle Nerve, 12, pp.410~419 (1989)
- Malas F. U., "Etiological factors in thoracic outlet syndrome", Orthopedics, 30, pp.425~ (2007)
- Stallworth J. M., "Diagnosis and management of thoracic outlet syndrome", Arch Surg, 119, pp.1149~1151 (1984)
- Cruz-Martinez A., "Electrophysiological assessment in neurogenic thoracic outlet syndrome", Electromyogr Clin Neurophysiol, 41, pp.253~256 (2001)
- "1995", 20
- Hwang J. J., "The surgical outcome of thoracic outlet syndrome", Korean Soc Thorac Cardiovasc Surg, 38, pp.844~848 (2005)
- Han S., "Transaxillary approach in thoracic outlet syndrome: the importance of resection of the first-rib", Eur J Cardiothorac Surg, 24, pp.428~433 (2003)
- Jordan S. E., "Diagnosis of thoracic outlet syndrome using eletrophysicologically guided anterior scalene blocks", Ann Vasc Surg, 12, pp.260~264 (1998)
- Jordan S. E., "Selective botulinum chemodenervation of the scalene muscles for treatment of nenurogenic thoracic outlet syndrome", Ann Vasc Surg, 14, pp.365~369 (2000)