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Histochemical and Morphometric Studies

Herbert I. Machleder, MD; Franz Moll, MD; M. Anthony Verity, MD

Arch Surg. 1986;121(10):1141-1144.

Abstract
• Histochemical studies and morphometric fiber type analysis were done on biopsy specimens of anterior scalene muscle (ASM) from patients with thoracic outlet compression syndrome (TOS), without structural abnormality. Hypertrophy and atrophy factors were determined from muscle fiber histograms of ASM from controls, patients with TOS, and after scalene tenotomy. Scalene muscle from patients with TOS showed marked type 1 (tonic contracting) fiber predominance (85.1%±5.1%) and type 1 fiber hypertrophy (55.6±2.7 µm). After tenotomy there is a reduction of type 1 fiber representation, selective atrophy in the type 1 fiber system (atrophy factor, 0.66 ± 0.24), and increase of type 2 fibers. These distinctive changes indicate that ASM is uniquely structured in fiber composition to sustain prolonged contraction. The ASM in patients with TOS demonstrates an extraordinary adaptive transformation and recruitment response in the type 1 fiber system reflecting chronic increased tone or motor neuron stimulation. These observations form a basis for clarifying the structural and pathophysiologic changes in TOS.

(Arch Surg 1986;121:1141-1144)

Author Affiliations
From the Departments of Surgery (Drs Machleder and Moll) and Neuropathology (Dr Verity), UCLA School of Medicine.

Footnotes
Accepted for publication Aug 7, 1986.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, Jan 17, 1986.

Reprint requests to 72-182A, UCLA Medical School, 10833 LeConte Ave, Los Angeles, CA 90024 (Dr Machleder).

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