Possible role of the botulinum toxin in the management of neurogenic thoracic outlet syndrome: a systematic review [* Cross-Reference *]

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Alban Fouasson‐Chailloux; Thomas Jäger; Pauline Daley; Andrea Falcone; Christophe Duysens; Daniel Estoppey; Michel Merle; Germain POMARES, 2026, "Possible role of the botulinum toxin in the management of neurogenic thoracic outlet syndrome: a systematic review [* Cross-Reference *]", https://lore.list.lu/citation?persistentId=perma:LIST.GVX1BI, LIST Open Repository, V1
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Description
INTRODUCTION: Thoracic outlet syndrome (TOS) is related to the compression and/or the traction of the upper-limb neurovascular bundle, responsible for a chronic painful impairment. Neurogenic TOS (NTOS) is the most common manifestation. It remains a challenging diagnosis and its treatment is also difficult. Botulinum toxin (BTX) has been described to help both the diagnosis and the symptoms improvement. EVIDENCE ACQUISITION: A systematic literature research was performed using PubMed, ScienceDirect, and Embase databases to collect studies reporting the use of BTX in NTOS management. We followed the PRISMA guidelines, and the included studies were evaluated using the GRADE approach. EVIDENCE SYNTHESIS: We included 10 original articles representing 555 patients. Various outcomes were considered, and results varied from a study to another. Symptoms relief varied from an absence of BTX effectiveness to 84.1% of improvement; relief duration was also reported from none to 88 days. BTX injections were debatable predictors of surgical procedure successes due to low evidence. There was a huge gap between the studies concerning side-effects of the BTX procedures, from none to 100% of the patients. CONCLUSIONS: There is no evidence for considering BTX injection as a validated tool for the management of NTOS. There might be a slight effect on symptoms, but outcomes are very variable, which prevents further interpretations. The use of BTX should be evaluated in larger prospective cohorts with more standardized outcomes. (2023-09-22)
***This entry has been automatically imported via OpenAlex by LIST harvest scripts. Please refer to https://doi.org/10.23736/s1973-9087.23.07815-2 for the original and latest version of the publication*** (2026-07-01)
Subject Medicine, Health and Life Sciences
Keyword Medicine, Botulinum toxin, Physical medicine and rehabilitation, Intensive care medicine, Surgery
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