I kawr, i kekawrte, a nih loh leh i kutphahah natna i nei reng em? Hetiang dinhmun hi Thoracic Outlet Syndrome (TOS) a ni thei!

A châng chuan i kawr leh i ke aṭanga i kut hnuai lam thlenga natna mak tak emaw, rilru hahna emaw i nei ṭhin em? He natna hi thil rit i chawi emaw, i kut i han chawi emaw hian a pung mai thei. Hetiang symptoms i neih chuan a chhan chu hming buaithlak deuh nei condition a ni thei. Vawiin hian chutiang dinhmun kan sawi dawn a, chu chu Thoracic Outlet Syndrome (TOS) . A hming hi i hriat chuan hlauhawm deuhin a lang thei a, mahse, a chanchin dik taka hriattir i nih chuan harsatna tam tak i tihziaawm thei a ni.

Thoracic Outlet Syndrome hi eng nge ni?

A awlsam zawngin, Thoracic Outlet Syndrome (TOS) hi i kawr hnuai leh i rilru chunglam nerve emaw thisen kalna kawng emaw compression avanga symptoms awmkhawm a ni. Hei hi a hming dang chu "thoracic outlet" tih a ni.

I kawr leh i rilru inkarah hian kawngkhar ang maia hmun tlemte a awm ang tih han ngaihtuah teh. Hei hi doctor-te'n "Thoracic Outlet" an tih chu a ni. He space hmang hian i kut lama kal nerve pawimawh tak tak te, chubakah i kut thlenga thisen phurtu arteries leh i kut atanga thisen i thinlunga thawn kirtu veins te pawh a paltlang thin. Chung zinga pawimawh ber chu brachial plexus, i kut thlenga kal nerve network, leh subclavian artery leh vein te hi a ni.

A tlangpuiin he hmun "thoracic outlet" an tih hi a lian tawk a, heng nerve leh thisen kalna kawngte hian engmah tibuaitu awm lovin an kal tlang thei a ni. Mahse, a chang chuan he hmun hi kan taksaa taksa peng hrang hrang (anatomical variation) vang emaw, kan kawr emaw, kan rilru emaw a hliam vang emaw hian a tawi thei hle. Chutah chuan buaina chu a intan ta a ni. He hmun hi a tawi deuh chuan a chhunga kal nerve emaw thisen kalna kawng emaw te chu a hnuaia ruh emaw, taksa ruh emaw te hian an nawr tan thin. He pressure hian i kut, i kephah leh i kawng a na leh a natna ang chi symptoms a thlen thin. Heng symptoms te hi inzawm lo leh chi hrang hrang a awm thei a, chuvangin hei hi TOS condition anga hriat theih nan hun rei tak a ngai thei bawk.

Mahse, lungngai suh. Mi tam tak chuan physical therapy leh painkiller ang chi enkawlna awlsam tak hmangin hahdamna an hmu thei a ni. Mahse, chutiang chuan a puih loh chuan emaw, thisen kal dan a tikhawtlai nasa hle a nih chuan operation neih a ngai mai thei.

TOS chi hrang hrang a awm em?

Ni e, doctor-te chuan TOS hi chi thum-ah an ṭhen a, chu chu he throbbing thlentu a zirin a ni:

Neurogenic TOS (Nerve compression avanga Tos lo awm) .

Hei hi TOS chi khat hman tlanglawn ber a ni . TOS vei zawng zawng zinga 95% vel chuan hetiang chi hi an nei a ni. Heta thil thleng hi ``Brachial plexus``, i kawr atanga i kawr atanga i kut thlenga kal nerve network chu a compress a ni. Kum 30 hnuai lam zingah a awm tam ber. Repetitive stress injuries - a bik takin infiamna lamah - leh kawr hliam nghal, car accident atanga ``Whiplash`` ang chi te hi a chhan ber a ni.

TOS hi venous congestion (Venous TOS) avanga lo awm a ni.

Hei hi i ``Subclavian vein`` a lo lut a, hei hi thisen kalna kawng lian ber a ni a, chu chu kut atanga thisen bawlhhlawh chu thinlung thlenga phur kir leh thin a ni. It occurs more often in men , usually between the ages of 20 and 30. Symptoms hi arm hman tam ber (`dominant arm`) ah a lang fo thin.

TOS hi arterial compression avanga lo awm (Arterial TOS) .

Hei hi TOS chi hrang hrang zingah chuan a tlem ber a ni . TOS vei zawng zawng zinga 1% vel a nghawng a ni. Mahse, kum 40 hnuai lam kutah thisen zam nghal vat chhan ber a ni a, he TOS chi hi i subclavian artery-ah a awm a, chu chu i thinlung atanga i kut thlenga oxygenated thisen phurtu thisen kalna kawng lian ber a ni. Pianpui atanga lo awm a ni fo thin. Entirnan, kawr chhunga extra rib (cervical rib) awm hi a ni. Cervical rib vei zinga 70% vel chu hmeichhia an nih avangin he TOS chi hi hmeichhiaah a tam zawk.

Doctor-te chuan venous leh arterial TOS chi hnih hi an inzawm khawm a, "Vascular Thoracic Outlet Syndrome" an ti ṭhin. A chi hnih hian natna lan chhuah dan tihziaawmna tur leh harsatna awm lo turin operation an mamawh tlangpui. Nerve nena inzawm TOS (Neurogenic TOS) hian physical therapy leh exercise lakah a chhang tha hle a, mahse mi thenkhat chuan operation an mamawh mai thei.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Zirchiangtute sawi dan chuan kum tin:

• Neurogenic TOS hi mi 40,000 zinga pakhat vel ah a awm thin.
• Venous TOS hi mi maktaduai 1.25 zinga pakhat vel ah a awm thin.

Mahse, he natna hi dik taka hriat a harsat avangin he natna vei tak tak hi a tam zawk thei hle.

TOS natna lan chhuah dante chu engte nge ni?

TOS symptoms hi i taksa chunglam sir khatah (ka kawng, i rilru chunglam, i kekawrte, kutphah emaw, kut zungtang emaw) ah a awm tlangpui. Hetiang hi i tawng thei a ni:

• Natna: He natna hi i kut i chawi sang chuan a pung thei.
• Numbness emaw "crawling" tih hriatna emaw.
• Numbness, kut ah engmah hriat loh .
• Kut chak lohna.
• Kut a hring emaw, a rit emaw.
• Vun rawng a inthlak (vun chu a dum emaw, a sen emaw a inthlak).
• Vun khawih hian a lum tih hriat.
• Kut zungtang hliam hi a dam theih nan hun rei tak a ngai a ni.

Heng symptoms te hi TOS i neih chi hrang hrang a zirin a danglam thei. A chhan chu a natna lan chhuahna chu eng nge compress (nerve emaw thisen kalna emaw) ah a innghat a ni. A dik zawka sawi chuan hetiang hi an ni:

• I ``Brachial plexus'' hi i kut hian a chetna leh a hriatna a hmuhna hmun a ni. Chuvangin, he nerve network hi a thinrim chuan natna leh rilru hahna ang chi thil a thleng thin.
• I subclavian vein hi i kut atanga thisen i thinlungah a phur kir leh thin a ni. Chuvangin, he vein hi a block chuan i kut chhunga thisen chu a chhuak tha thei lo va, chu chuan i kut chu a ti hring a, a rit hle niin a lang.
• I subclavian artery hian i kut ah oxygen tamna thisen a pe chhuak thin. Chuvangin, he artery hi a block chuan i kut leh kut zungtang ah thisen kal a tlahniam thin. Hei hian i kut a ti na thei a, a ti na thei a, a ti na thei a, a vawt thei bawk.

TOS natna hi eng ang nge a nih? Angina nen a inthlau em?

TOS hian i kawr, i rilru chunglam, i kephah leh i kut a na thei a ni. Hei hi natna dull ache a ni thei a, nagging pain ang mai a ni a, i kut i sawn chuan a na zual thei bawk.

Mi thenkhat chuan TOS natna hi angina , thinlung natna nen an inzawm tir thin. Angina chu heart muscle-in oxygen a hmuh tlem vangin rilru natna a ni. Mahse an pahnih inkarah hian danglamna pawimawh tak tak a awm a:

• TOS natna hi kea kal hian a lo thleng lo va, a na zual lo bawk. Mahse, angina natna hian a nei tlangpui. Angina hian natna dang a zui thei a, chu chu thawk hah, thinlung thawk chak, leh luak chhuak te hi a ni.
• TOS natna hi a natna vei kut chu chawi sang a nih chuan a pung tlangpui. Hei hi angina nen chuan a thleng lo.

Pawimawh: TOS hi heart attack emaw stroke emaw nen inzawm tir suh!

Hei hi i ngaihtuah reng tur a ni . TOS natna lan chhuah dan thenkhat chu natna khirh tak tak, heart attack leh stroke te nen a inang thei a, chu chu emergency medical treatment a ngai a ni. Entir nan:

• Chest pain , a bik takin a lo awm nghal a, beisei loh takin a lo awm a nih chuan heart attack chhinchhiahna a ni thei. Mahse, heart attack-ah chuan symptom dang a awm thei a, chu chu thawk hah, pum na, thawk hah, thih hlauhna te hi a ni.
• Taksa sir khata chak lohna hi paralysis chhinchhiahna a ni thei. Mahse, paralysis hian chhinchhiahna dang a nei thei bawk a, chu chu thusawi thiam loh, hmai sir khat emaw, a sir lehlamah emaw a tlakchhiat, leh mit hmuhna hloh nghal mai te hi a ni.

Heart attack emaw stroke emaw symptoms i neih chuan doctor pan nghal tur a ni. Hengte hi nunna atana hlauhawm emergency a ni. Enkawlna tihkhawtlai hian thihna a thlen thei.

TOS awm chhante chu engte nge ni?

Doctor-te chuan TOS thlentu hi chi thum-ah an ṭhen a, chungte chu:

Pianpui atanga lo chhuak a ni

Hengte hi i pian tirh laia i taksaa inthlak danglamna thenkhat chu an ni. Entirnan, i kawr chhungah extra rib (a `cervical rib`) neiin i piang mai thei. Hei hi rib hmasa ber nen a inhnaih a, a inzawm pawh a ni mai thei. A nih loh leh i ruhroah, i kawr ruh, a nih loh leh i ruh (ligament)-ah thil danglam tak i nei thei bawk. Heng inthlak danglamna te hian `thoracic outlet` chhunga nerve emaw thisen kalna kawng emaw ah pressure a siam thei a ni.

Accident avang hian (Traumatic) .

Hengte hi i kawr leh i rilru chunglam hliam nghal mai a ni. Motor accident avanga hliam, a bik takin whiplash avanga hliam hi chutiang entirnan a langsar hle. Ngaihtuah teh, three-wheeler i khalh a, accident i tawk a, i kawr a hrual nghal a nih chuan hetiang hi a thleng thei a ni.

Hnathawh mek (Functional) avang hian .

Chumi awmzia chu thil pakhat i tih nawn leh chuan "thoracic outlet" chhunga thil awmte chu a chhe vek tihna a ni. Hei hi infiammi (a bik takin cricketer - bowler, batsman, leh swimmer) zingah chuan a chhan tlangpui a ni a, a chhan chu kut inthlak chak lutuk vang a ni. Entirna dang chu hna thenkhatah chuan lu chunga thil dah reng hi a ni. Nilengin computer hmaa a dinhmun tha lo taka thawk pawh hi a hlauhawm thei hle.

Mi thenkhat chu TOS vei theihna tur risk factors neia piang ni mahse, an kawngah accident nghal emaw, hna chi khat an thawh reng emaw a, a chhiat hma loh chuan symptom engmah an nei lo thei.

Tute nge TOS vei theihna chance sang zawk?

TOS vei theihna chance sang zawk i nei thei a, chu chu:

• Infiamna i khelh fo chuan kut emaw, ke emaw i tih nawn fo thin chuan. Entirnan: cricket, tui chawi, golf, volleyball.
• Weightlifting i tih chuan.
• I kekawrte chungah bag rit tak tak i chawi fo emaw, i lu chungah thil i chawi fo thin a nih chuan. (e.g., in sakna lama thawkte, bungraw phurtute)
• I kawr emaw, i hnungzang emaw-ah hliam i tuar a nih chuan, entirnan `(Whiplash)`.
• I rilru chunglam emaw, i hnungzang emaw-ah tumor emaw lymph node lian tak tak i neih chuan.
• I thut emaw, ding emaw dinhmun a tha lo a nih chuan. (Entirnan: computer-a nilengin an hnungzang ben chunga hnathawk)

TOS hi natna khirh tak a ni em? Eng harsatna nge awm thei?

Enkawl loh chuan Thoracic Outlet Syndrome hian harsatna lian tak a thlen thei a ni. Chung zinga ṭhenkhat chu:

• Armpit leh a kaihhnawih vein-a thisen zam (`Axillo-subclavian vein thrombosis`).
• Kut a hring leh natna awm reng, a bik takin venous TOS (`Venous TOS`) nei te tan.
• Tissue thihna (`Gangrene`).
• Thisen kal tlem vangin kut zungtang-ah ischemic ulcer a awm thin.
• Nerve chhiatna awm reng.
• Pulmonary embolism – Hei hi natna hlauhawm tak a ni.

Chuvangin, i hmu em, hei hi harsatna tenau tak mai a ni tih ngaihtuah mai mai chu thil tha a ni lo. Diagnose leh enkawl hmasak a pawimawh hle.

Engtin nge TOS i nei tih chiang taka i hriat theih ang? (Diagnosis) tih a ni.

Doctor chuan a enfiah ang che a, TOS i neih leh neih loh hriat nan i medical history a zawt ang che. Physics exam neih chhung hian i doctor chuan movement test thenkhat tihsak turin a ti ang che. Entir nan:

• `Upper limb tension test` (Upper limb a nghawng em tih enfiahna) .
• `Elevated arm stress test` tih a ni

Heng test neih chhung hian i doctor chuan thil awlsam tak tak, i kut chawi sang, i lu tihher, leh i kut vawn ang chi te a ti ang che. Chumi hnuah chuan eng chetnain nge natna emaw, chhinchhiahna dang emaw a thlen tih a en ang. A result hian a natna hi a hriat theih nan a pui thei a ni.

Chu bakah, i doctor chuan TOS i vei tih finfiah nan leh i natna lan chhuah chhan dang hriat loh nan lab test leh imaging test a ti thei bawk.

Eng test dang nge i tih thin?

Heng test zinga pakhat emaw a aia tam emaw i neih a ngai mai thei:

• Thisen test neih a ni .
• A rilru a buai em em a.
• A rilru leh/ emaw ruhro CT scan .
• EMG test (`Electromyography (EMG)`) – Hei hian taksa ruh leh nerve hnathawh dan a enfiah thin.
• I thisen kalna kawngte chu magnetic resonance angiography (MRA) hmanga enfiah a ni .
• Magnetic resonance imaging (MRI) hmanga rilru leh/ emaw ruhro .
• Nerve conduction study – Hei hian nerve kal tlanga message kal chak dan a teh a ni.

Heng test te hian doctor chu a hriat theih nan a pui thei a ni:

• Congenital abnormalities (e.g., cervical rib) a awm leh awm loh enfiah thin ang che.
• I thisen kalna kawng leh thisen kal tlanga thisen kal dan enfiah rawh.
• Heng symptoms thlentu ni thei dinhmun dang pawh paih bo rawh.
• I taksa ruh leh nerve hnathawh dan en rawh.
• Pressure awmna hmun dik tak chu zawng chhuak rawh.

TOS enkawlna tur engte nge ni?

TOS enkawl dan hi TOS i neih chi leh i symptoms a zirin a inang lo. Enkawlna tum ber chu natna lan chhuah dan tihtlem leh harsatna awm thei tur ven hi a ni. I doctor chuan eng enkawlna nge i tan a tha ber tih a rel ang.

Enkawl dan tur thenkhat chu hetiang hi a ni:

• Physical therapy: Hei hi neurogenic TOS enkawlna line hmasa ber a ni. Physics therapist chuan i kawr leh i kekawrtea i chetna range a tipung thei a, i taksa ruhte a tichak thei a, i dinhmun dik tak i vawng reng thei bawk. Hei hi neurogenic TOS vei tam tak tan chuan hahdamna ropui tak a ni.
• Natna tidamtu: I doctor chuan natna tidamtu damdawi, NSAIDs (non-steroidal anti-inflammatory drugs) te a pe thei a, chu chu damdawi dawrah i lei thei ang.
• Thisen zam venna emaw, tithianghlim thei damdawi: 1.1.Arterial emaw venous TOS nei te chu `thrombolytic therapy` (thisen chhuak tichhe thei enkawlna) hmangin tanpui theih an ni. Hei hian thisen zam awmsa tihthianghlim nan leh thisen thar a lo awm loh nan IV line emaw catheter emaw hmanga damdawi pek a huam a ni. I doctor chuan `anticoagulant damdawi` a pe thei bawk.
• Surgery: TOS nei tam tak chuan thisen kalna kawng emaw, thisen kalna kawng emaw a tikhawlo a, operation an mamawh a ni. Nerve compress tu TOS vei thenkhat pawhin enkawlna dangin a puih loh chuan operation an mamawh thei bawk. Surgeon te hian TOS chi leh i taksa chi hrang hrang a zirin surgical technique hrang hrang an hmang thin. Entirnan, decompression surgery hian compression thlentu ruh emaw tissue pangngai lo chu a paih chhuak thin. Surgery dangte chuan thisen kalna kawnga structural problem awmte siamthatna hmangin thisen kal dan a tichak thei a ni. I doctor chuan operation i mamawh leh mamawh loh te, engtin nge a tih tih te, a hlauhawmna te chu a hrilhfiah ang che.

TOS hi a mah chauhin a tha chho dawn em ni ?

Ni lo, symptoms te chu a mah chauha a dam leh hun nghak suh. TOS -a symptoms i neih chuan doctor pan nghal rawh. Physics therapy ang chi thil awlsam tak takte hian natna lan chhuah dan a tiziaawm thei fo laiin, mi thenkhat chuan harsatna lian tham lo thleng tur ven nan operation emaw, enkawlna dang emaw an mamawh mai thei. I doctor chuan i tan eng treatment plan nge tha ber tih a hrilh ang che.

TOS hi ven theih a ni em?

TOS hi ven theih reng a ni lo. A chhan tam tak chu kan thunun theih loh (e.g., genetic factors) a nih avangin, i hlauhawmna tihtlem nan thil engemaw i tih theih a awm a:

• Kut chet fo ngai sport i khelh chuan i coach emaw trainer emaw nen i kekawr bul vel ruh tichak thei exercise chungchang sawipui rawh.
• I hnathawhna hmunah chuan rit phurh emaw, hna sang tak thawh emaw a ngai a nih chuan, i hliam theihna tihtlem thei exercise chungchang doctor nen sawiho rawh.
• Posture dik tak vawng reng rawh. Thut, ding leh hnathawh laiin i hnungzang chu dinglam hawiin dah la.
• Hmun khatah awm reng suh. Tho la, darkar khatah vawi khat tal kal kual la, i taksa chu tlem tal tizau rawh.

TOS i neih chuan eng nge i beisei ang? / Engtin nge i in enkawl theih ang?

TOS vei tan chuan TOS an neih chi hrang hrang a zirin outlook a inang lo. I doctor chuan i outlook chu a hrilh thei ber che a ni.

TOS i neih chuan i doctor in enkawl dan tur a hrilh ang che. I doctor chuan hetiang hi a hrilh thei che a ni:

• I kekawr ipte chunga bag rit phur leh i lu chunga thil chawi chu a theih ang anga tihtlem emaw, titawp emaw rawh.
• Physics therapist nen thawk ho rawh. Exercise a pek che chu ti rawh.
• I taksa ruh tichak tur leh i dinhmun tihchangtlun nan in lama i tih theih exercise te ti thin ang che.
• Symptoms tipung thei movement thenkhat kha tihtlem emaw, pumpelh emaw .Nitin nunphung thlak danglam rawh.

Engtikah nge doctor i hmuh ang? / Doctor hnena zawhna zawh tur

Symptom thar i neih chuan emaw, i symptoms a danglam chuan doctor nen inbia ang che. Doctor i hmuh fo tur leh test neih a ngai leh mamawh loh a hrilh ang che.

Tun hnaia Thoracic Outlet Syndrome i vei tih hmuhchhuah i nih chuan i doctor zawh theih tur zawhna thenkhat chu hetiang hi a ni:

• Eng ang Thoracic Outlet Syndrome nge ka neih?
• Hei hi eng nge a chhan?
• Eng enkawlna nge i rawt? Engtikah nge an tih tur?
• Engtin nge enkawlna a hlawhtling em tih kan hriat theih ang?
• Enkawlna hian eng hlauhawmna nge a neih?
• Ka nitin nunphung pangngai emaw, ka tih dan pangngaiah eng inthlak danglamna nge ka neih?
• In lamah eng nge ka tih theih ang, symptoms tihziaawm nan?
• Ka thlirna chu eng nge ni?

He thuziak atanga hriatreng tur thil (Take-Home Message) .

Thoracic Outlet Syndrome (TOS) hian i nun pangngai a tibuai thei a ni. I infiamna emaw, hnathawhna emaw aṭanga chawlh hahdam a ngai chu a lungchhiatthlâk thei hle. Mahse dawhthei rawh. Physics therapy emaw, enkawlna dang emaw hmanga i in enkawl hian i chakna i nei leh thei a, hun rei tak chhung chu i dam tha thei bawk.

A pawimawh ber chu symptoms i neih chuan doctor advice lak hi a ni a, ngaihthah ai chuan. Hriat hmasak hian enkawlna a ti awlsam a, harsatna awm theihna a ti tlem bawk.

I dinhmun, i enkawl dan tur, i hmalam hun tur chungchangah zawhna i neih chuan i doctor nen inbia ang che.

` Thoracic Outlet Syndrome, TOS, kawng na, kut na, ke ruh na, rilru hah, nerve compression