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  • Academic
    thar95@stanford.edu
    University - Student Department: Graduate School of Business Position: Graduate, Business
    University - Student Department: School of Medicine Position: Graduate, Medicine

Additional Info

  • Mail Code: 4810

All Publications

  • Neurogenic Thoracic Outlet Syndrome in Division 1 Collegiate Athletes: Presentation, Diagnosis, and Treatment. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Olson, E. M., Dyrek, P., Harris, T., Fereydooni, A., Lee, J. T., Kussman, A., Roh, E. 2023

    Abstract

    Athletes who engage in repetitive upper-extremity exercise are susceptible to neurogenic thoracic outlet syndrome (nTOS). We sought to identify typical presenting symptoms and common findings on diagnostic workup, in addition to evaluating rates of return to play following various treatment interventions.Retrospective chart review.Single institution.Medical records of Division 1 athletes containing the diagnosis of nTOS between the years 2000 and 2020 were identified. Athletes with arterial or venous thoracic outlet syndrome were excluded.Demographics, sport, participation status, clinical presentation, physical examination findings, diagnostic workup, and treatments provided.Rate of return to play (RTP) to collegiate athletics.Twenty-three female and 13 male athletes were diagnosed and treated for nTOS. Digit plethysmography showed diminished or obliterated waveforms with provocative maneuvers in 23 of 25 athletes. Forty-two percent were able to continue competing despite symptoms. Of the athletes who were initially unable to compete, 12% returned to full competition after physical therapy alone, 42% of those remaining were able to RTP after botulinum toxin injection, and an additional 42% of the remaining athletes RTP after thoracic outlet decompression surgery.Many athletes diagnosed with nTOS will be able to continue competing despite symptoms. Digit plethysmography is a sensitive diagnostic tool for nTOS to document anatomical compression at the thoracic inlet. Botulinum toxin injection had a significant positive effect on symptoms and a high rate of RTP (42%), allowing numerous athletes to avoid surgery and its prolonged recovery and associated risks.This study demonstrates that botulinum toxin injection had a high rate of return to full competition in elite athletes without the risks and recovery needed for surgical intervention, suggesting that this may be a good intervention especially among elite athletes who only experience symptoms with sport-related activities.

    View details for DOI 10.1097/JSM.0000000000001162

    View details for PubMedID 37207307

  • Impact of Scalene Muscle Botulinum Toxin Injection With and Without Surgery in Neurogenic Thoracic Outlet Syndrome. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Fereydooni, A., Ho, V. T., Olson, E. M., Dyrek, P., Harris, T., Kussman, A., Roh, E., Lee, J. T. 2022

    Abstract

    Scalene blocks are part of both the diagnostic and treatment algorithm for patients presenting with symptoms of neurogenic thoracic outlet syndrome (nTOS). However, there is a paucity of data on the utility of scalene botulinum toxin injection (BTI) before surgical decompression. We sought to determine the impact of BTI with and without surgery at a multidisciplinary referral center.Retrospective cohort study.Single institution tertiary academic center, 2011 to 2020.Seventy-seven consecutive patients.Scalene muscle BTI for nTOS with or without surgical decompression.Pain relief and Quick Disability of the Arm, Shoulder and Hand (QDASH) score.Seventy-seven patients, with a mean age of 31.4 years, had BTI for symptoms of nTOS. All patients underwent pretreatment physical therapy through the Edgelow protocol for a mean duration of 3.4 months. However, 72.7% had dynamic vascular compression on duplex ultrasound with provocative maneuvers and 85.7% had a positive physical examination finding. After BTI, 77.9% reported subjective relief, confirmed by an improved QDASH disability score. Thirty-one patients (40.3%) then went on to have further persistent symptoms and proceeded with first rib resection. After BTI + Surgery, 96.8% reported symptomatic relief and had a median QDASH score improvement of 21 (range: 10-40), with all reaching minimal clinically important differences in the QDASH score after combination therapy.In this reported series of chemodenervation in patients with nTOS, BTI is helpful in alleviating symptoms before definitive surgical decompression. BTI followed by first rib resection provides additional symptom improvement over BTI alone.

    View details for DOI 10.1097/JSM.0000000000001094

    View details for PubMedID 36367782

  • Access to American College of Surgeons Committee on Trauma-Verified Trauma Centers in the US, 2013-2019. JAMA Choi, J., Karr, S., Jain, A., Harris, T. C., Chavez, J. C., Spain, D. A. 2022; 328 (4): 391-393

    View details for DOI 10.1001/jama.2022.8097

    View details for PubMedID 35881133

  • Access to American College of Surgeons Committee on Trauma-Verified Trauma Centers in the US, 2013-2019 JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Choi, J., Karr, S., Jain, A., Harris, T. C., Chavez, J. C., Spain, D. A. 2022; 328 (4): 391-393

    View details for Web of Science ID 000839108600018

  • Impact of Scalene Muscle Botulinum Toxin Injection with and without Surgery in Neurogenic Thoracic Outlet Syndrome Fereydooni, A., Ho, V. T., Olson, E., Dyrek, P., Harris, T., Kussman, A., Roh, E. Y., Lee, J. T. MOSBY-ELSEVIER. 2021: E410

    View details for Web of Science ID 000707158200201

  • Predictors Of Relief Following Botulinum Injection For Thoracic Outlet Syndrome Olson, E., Dyrek, P., Fereydooni, A., Harris, T., Lee, J. T., Kussman, A., Roh, E. Y. LIPPINCOTT WILLIAMS & WILKINS. 2021: 377

    View details for Web of Science ID 000693955700413

  • Predicting Return To Play In NCAA Division 1 Athletes With Neurogenic Thoracic Outlet Syndrome Dyrek, P., Olson, E., Fereydooni, A., Harris, T., Kussman, A., Roh, E., Lee, J. T., Segovia, N. LIPPINCOTT WILLIAMS & WILKINS. 2021: 390

    View details for Web of Science ID 000693955700448

  • The Shrinking Brain: Cerebral Atrophy Following Traumatic Brain Injury ANNALS OF BIOMEDICAL ENGINEERING Harris, T. C., de Rooij, R., Kuhl, E. 2019; 47 (9): 1941–59

    View details for DOI 10.1007/s10439-018-02148-2

    View details for Web of Science ID 000489738300008