What is a chest wall anomaly?
Chest wall anomaly (pectus) is defined as the deformities of the anterior part of the chest, which usually start at birth and increase afterwards. It is encountered 1 in 300-400. It is most commonly seen in 2 forms: protruding anterior chest (pectus carinatum) or depressed anterior chest (pectus excavatum). Other chest wall abnormalities are much more exceptional.
What is Pigeon Chest?
A protruding anterior chest wall is called the pectus carinatum or pigeon breast. This is a developmental anomaly, not actually a disease, caused by the ribs pushing the sternum (the bone of faith) outwards as they grow. The front of the chest is protruding forward.
It becomes especially prominent during the growth period in adolescence. It is more prominent if the person is thin. It can affect the person’s social life and psychology. These people may feel uncomfortable going to the beach or pool and being naked due to the appearance of their chest.
Pigeon chest disorder causes only cosmetic problems and is not a medical problem, hence, can be treated with surgery based on the individuals’ wish.
What is Pectus Excavatum?
A collapsed anterior chest is called pectus excavatum. While this anomaly of the chest wall is often only a cosmetic problem, if the anterior chest wall is excessively pusheded inward, it can put pressure on organs such as the heart and lungs and impair their function. In addition, children with this deformity may feel socially uncomfortable because they are embarrassed by this deformity in their chests and it may also cause psychological problems. Surgery is necessary to correct this deformity for both cosmetic reasons and in cases of severe compression of the heart and lungs. Childhood and early adolescence (10-15 years) are more suitable for surgery.
What are the other chest wall deformities?
In the case of asymmetric pectus, the anterior part of the rib cage may be dislocated on one side and sunken on the other. Treatment of this condition is more complicated.There may also be anomalies such as a poorly developed anterior chest bone – a cleft sternum – or poorly developed ribs, cartilage or muscles in the anterior chest. Surgery is rarely necessary for such conditions.
How to treat chest wall anomalies?
Chest wall anomalies called pigeon chest or pectus excavatum are corrected with “pectus” surgeries.
While pectus surgeries were performed with the open method until 10-15 years ago, in recent years they are mostly performed with the closed method called minimally invasive methods.
In the open method, the deformed ribs are partially cut and corrected, and the anterior sternum is also cut and fixed in a normal position with a metal rod underneath. Although it is a more controlled method, it has many incisions and therefore cosmetic disadvantages. There may be some postoperative pain. Complicated chest wall deformities should be treated this way.
What is endoscopic chest wall surgery?
Pectus surgeries can also be performed with the closed method. In the closed method, the deformity in the anterior chest is corrected with a metal rod (bar) placed under or over the anterior chest bone with the help of endoscopy. It is an operation that requires Professional medical experience. Patients have less scarring after the closed method of chest wall anomaly correction, which takes less time. Early postoperative pain rate may be slightly higher compared to open surgery method.
The metal rods used in both open and closed methods of surgery must be removed within 6 months to 3 years.
What is important after pectus surgery?
The ideal age for pectus surgery is 12-15 years. Patients should avoid contact sports for a few months after surgery. It is very rare to experience long term pain.
Does chest wall anomaly recur?
The pectus surgery generally results in satisfaction. Relapses are extremely rare, especially after the removal of the bar under the sternum.
