Thorax Deformities

What is Pectus Carinatum?

Pectus carinatum (“pigeon chest”) is a common condition in which the breastbone and ribs are pushed outward. Pectus carinatum occurs more often in males than females (4:1 ratio), and develops somewhat later in males than it does in females. While it may be seen in very young children, it usually becomes more obvious during or after a growth spurt in puberty.

What causes Pectus Carinatum?

The cause of pectus carinatum is currently unknown, but the fact that it tends to recur in families suggests that genetics may play a role.

What are the Signs and Symptoms of Pectus Carinatum?

For the most part, children with pectus carinatum do not have symptoms. If symptoms are present, they are typically mild and limited to occasional chest wall pain and tenderness

How is Pectus Carinatum Diagnosed?

Some patients may have a chest X-ray during their initial evaluation. This helps the surgeon screen for other chest abnormalities or scoliosis. In severe cases of breathing symptoms, a pulmonary function test may help to determine how much lung function is compromised.

How is Pectus Carinatum Treated?

Fortunately, because the chest wall in children and adolescents is very soft and flexible, pectus carinatum usually can be corrected with bracing. Less than 10 percent of children with pectus carinatum need surgery to correct the problem.

In our center, orthotic treatment is applied to pectus carinatum patients. Our success rate in non-surgical treatment reaches 90%.

What is Pectus Excavatum?

Pectus excavatum is an abnormal development of the rib cage in which the sternum (breastbone) grows inward, resulting in a noticeable and sometimes severe indentation of the chest wall. Also known as “sunken chest” or “funnel chest,” pectus excavatum can be corrected with the minimally invasive surgical technique called the Nuss procedure or with traditional open surgery, known as the Ravitch procedure

What are the symptoms of pectus excavatum?

Due to the pectus, patients may have less space in the chest, which can limit heart and lung function. The symptoms can be both physical and psychological. Physical symptoms can include:

  • Shortness of breath with exercise.
  • Decreased stamina compared to peers.
  • Fatigue
  • Chest pain.
  • Irregular heartbeat.

How is pectus excavatum treated?

Pectus excavatum can be treated surgically. The primary goal of surgery for pectus excavatum is to correct the chest deformity to improve a patient’s breathing and cardiac function. 

The Nuss procedure: After a tiny camera is inserted into the chest to guide the procedure, two small incisions are made on either side of the chest, and a curved steel bar is inserted under the sternum. Individually curved for each patient, the steel bar is used to correct the depression and is secured to the chest wall on each side. The bar is left in place for 3 years and later removed as an outpatient procedure