Intraoperative thermographic monitoring during neurogenic thoracic outlet decompressive surgery

This article reports the use of thermography to monitor 123 plexus decompressions for neurogenic thoracic outlet syndrome. The diagnosis and management of this disease continues to be controversial. Questions about pathologic mechanisms, the extent and frequency of muscular entrapment, scar, and interdigitations, as well as their relative contributions, remain. Thermographic visualization of the operated extremity allowed us to map and correlate thermal changes with specific surgical manipulations, as well as to analyze the tissues resected to better answer these questions. Initial thermal abnormalities indicating, usually, ulnar entrapments or irritation, normalized sequentially as discrete entrapments were resected. Thermographic monitoring continues to provide surgically useful information in one third of operations.