Abstract
Children present with chest wall deformities to their pediatrician because of physiologic and psychologic causes. We have a 22-year experience in the operative management of more than 300 of these children. Initial evaluation should accurately categorize the deformity, determine the severity, assess for associated problems and refer the child at an appropriate time for further management. Pectus carinatum is the most common deformity that can cause physical pain from an intercostal neuropathy and psychologic pain from the unsightly protuberance. Poland syndrome is managed by early correction of the hand deformity and later correction of the chest wall deformity if necessary for psychologic or functional reasons. Jeune syndrome and failure of sternal fusion may have severe associated cardiopulmonary compromise. Each should be corrected in infancy for the best results.
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References
Clark JG, Grenville-Mathers R. Pectus excavatum.Brit J Dis Chest 1962; 56: 202–205.
Ravitch MM.Congenital Deformities of the Chest Wall and Their Operative Correction. Philadelphia, London, Toronto: WB Saunders Company, 1977.
Golladay ES, Char F, Mollitt DL. Children with Marfan's syndrome and pectus excavatum.South Med J 1985; 78: 1319–1323.
Haller JA Jr, Kramer SS, Lietman SA. Use of CT-scan in selection of patients for pectus excavatum surgery: a preliminary report.J Pediatr Surg 1987; 22: 904–906.
Cahill JL, Lees GM, Robertson HT. A summary of preoperative and postoperative respiratory performance in patients undergoing pectus excavatum and carinatum repair.J Pediatr Surg 1984; 19: 430–34.
Shamberger RC, Welch KJ. Cardiopulmonary function in pectus excavatum.Surg Gynecol Obstet 1988; 23: 615–622.
Mocchegiani R, Badano L, Lestuzzi C, Nicolosi GL, Zanutinni D. Relation of right ventricular morphology and function in pectus excavatum to the severity of the chest wall deformity.Am J Cardiol 1995; 76: 941–946.
Besier GD, Epstein SE, Stampfer M, Goldstein RE, Noland SP, Levitsky S. Impairment of cardiac function in patients with pectus excavatum with improvement after operative correction.NEJM 1972; 287: 267–272.
Shamberger RC, Welch KJ, Castaneda AR, Keane JF, Fyler DC. Anterior chest wall deformities and congenital heart disease.J Thorac Cardiovasc Surg 1988; 96: 427–432.
Golladay ES, Wagner CW. Pectus Excavatum: A 15-Year Perspective.South Med J 1991; 84: 1099–1101.
Haller JA, Jr, Shermeta DW, Tepas JJ, Bittner HR, Golladay ES. Correction of pectus excavatum without prostheses or splints: Objective measurement of severity and management of asymmetrical deformities.Ann Thorac Surg 1978; 26: 73–79.
Matsui T, Kitano M, Nakamura T, Shimizu Y, Hyon SH, Ikada Y. Bioabsorbable struts made from poly-L-lactide and their application for treatment of chest wall deformity.J Thorac Cardiovasc Surg 1994; 108: 162–168.
Poland A. Deficiency of the pectoral muscles.Guy's Hospital Reports 1841; 6: 191–193.
Whitley CB, Schwarzenberg SJ, Burke BA, Freese DK, Gorlin RJ. Direct hyperbilirubinemia and hepatic fibrosis: A new presentaton of Jeune syndrome (asphyxiating thoracic dystrophy).Am J Med Genet suppl 1987; 3: 211–220.
Davis JT, Ruberg RL, Leppink DM, McCoy KS, Wright CC. Lateral thoracic expansion for Jeune's asphyxiating thoracic dystrophy: A new approach.Ann Thorac Surg 1995; 60: 694–696.
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Golladay, E.S., Golladay, G.J. Chest wall deformities. Indian J Pediatr 64, 339–350 (1997). https://doi.org/10.1007/BF02845203
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DOI: https://doi.org/10.1007/BF02845203