Skip to main content
Log in

Radiological assessment of children with pectus excavatum

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess what degree of chest wall deformation changes statistically reliably after surgery, using pre-and postoperative radiological examination data.

Methods

Radiological chest examinations were performed for 88 children before and after remedial operations. Pre-and postoperative chest radiograph and CT were performed to measure transversal chest width; sagittal left chest side depth, sagittal right chest side depth, sternovertebral distance, and vertebral body length. Derivative indices were also estimated: Vertebral index (VI), Frontosagittal index (FI), Haller index (HI) and asymmetry index. Computerized assessment of data was used. For statistical analysis, the software “Statistica 6.0” was used.

Results

Postoperatively VI increased approximately by 2.37±2.72, FI decreased by 4.60±4.34, and HI value increased approximately up by 0.45±0.49. Statistically significant deformation index difference before and after surgery was not detected when VI was below 26.2 (p=0.08), FI was above 32.9 (p=0.079) and HI was less than 3.12 (p=0.098).

Conclusion

Preoperative CT and X-ray assessment of chest wall deformation degree is important for pediatric patients. The following deformation indices are indications for surgical treatment: VI>26, FSI<33 and HI>3.1.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Donnelly LF, Frush DP. Abnormalities of the chest wall in pediatric patients. AJR Am J Roentgenol 1999 December; 173(6): 1595–1601.

    PubMed  CAS  Google Scholar 

  2. Fonkalsrud EW, Dunn JC, Atkinson JB. Repair of pectus excavatum deformities: 30 years of experience with 375 patients. Ann Surg 2000 March; 231(3): 443–448.

    Article  PubMed  CAS  Google Scholar 

  3. Golladay ES, Golladay GJ. Chest wall deformities. Indian J Pediatr 1997 May; 64(3): 339–350.

    PubMed  CAS  Google Scholar 

  4. Saxena AK, Schaarschmidt K, Schleef J, Morcate JJ, Willital GH. Surgical correction of pectus excavatum: the Munster experience. Langenbecks Arch Surg 1999 April; 384(2): 187–193.

    Article  PubMed  CAS  Google Scholar 

  5. Suita S, Taguchi T, Masumoto K, Kubota M, Kamimura T. Funnel chest: treatment strategy and follow-up. Pediatr Surg Int 2001 July; 17(5–6): 344–350.

    Article  PubMed  CAS  Google Scholar 

  6. Haller JA, Jr., Scherer LR, Turner CS, Colombani PM. Evolving management of pectus excavatum based on a single institutional experience of 664 patients. Ann Surg 1989 May; 209(5): 578–582.

    Article  PubMed  Google Scholar 

  7. Kaguraoka H, Ohnuki T, Itaoka T, Kei J, Yokoyama M, Nitta S. Degree of severity of pectus excavatum and pulmonary function in preoperative and postoperative periods. J Thorac Cardiovasc Surg 1992 November; 104(5): 1483–1488.

    PubMed  CAS  Google Scholar 

  8. Ohno K, Nakahira M, Takeuchi S, Shiokawa C, Moriuchi T, Harumoto K, Nakaoka T, Ueda M, Yoshida T, Tsujimoto K, Kinoshita H. Indications for surgical treatment of funnel chest by chest radiograph. Pediatr Surg Int 2001 November; 17(8): 591–595.

    Article  PubMed  CAS  Google Scholar 

  9. Einsiedel E, Clausner A. Funnel chest. Psychological and psychosomatic aspects in children, youngsters, and young adults. J Cardiovasc Surg (Torino) 1999 October; 40(5): 733–673.

    CAS  Google Scholar 

  10. Croitoru DP, Kelly RE, Jr., Goretsky MJ, Lawson ML, Swoveland B, Nuss D. Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients. J Pediatr Surg 2002 March; 37(3): 437–445.

    Article  PubMed  Google Scholar 

  11. Hosie S, Sitkiewicz T, Petersen C, Gobel P, Schaarschmidt K, Till H, Noatnick M, Winiker H, Hagl C, Schmedding A, Waag KL. Minimally invasive repair of pectus excavatum—the Nuss procedure. A European multicentre experience. Eur J Pediatr Surg 2002 August; 12(4): 235–238.

    Article  PubMed  CAS  Google Scholar 

  12. Miller KA, Woods RK, Sharp RJ, Gittes GK, Wade K, Ashcraft KW, Snyder CL, Andrews WM, Murphy JP, Holcomb GW, III. Minimally invasive repair of pectus excavatum: a single institution’s experience. Surgery 2001 October; 130(4): 652–657.

    Article  PubMed  CAS  Google Scholar 

  13. Ohno K, Morotomi Y, Nakahira M, Takeuchi S, Shiokawa C, Moriuchi T, Harumoto K, Nakaoka T, Ueda M, Yoshida T, Yamada H, Tsujimoto K, Kinoshita H. Indications for surgical repair of funnel chest based on indices of chest wall deformity and psychological state. Surg Today 2003; 33(9): 662–665.

    Article  PubMed  Google Scholar 

  14. de Matos AC, Bernardo JE, Fernandes LE, Antunes MJ. Surgery of chest wall deformities. Eur J Cardiothorac Surg 1997 September; 12(3): 345–350.

    Article  PubMed  Google Scholar 

  15. Donnelly LF, Frush DP, Foss JN, O’Hara SM, Bisset GS, III. Anterior chest wall: frequency of anatomic variations in children. Radiology 1999 September; 212(3): 837–840.

    PubMed  CAS  Google Scholar 

  16. Nakahara K, Ohno K, Miyoshi S, Maeda H, Monden Y, Kawashima Y. An evaluation of operative outcome in patients with funnel chest diagnosed by means of the computed tomogram. J Thorac Cardiovasc Surg 1987 April; 93(4): 577–582.

    PubMed  CAS  Google Scholar 

  17. Willital GH. [Indication and operative technique in chest deformities (author’s transl)]. Z Kinderchir 1981 July; 33(3): 244–252.

    PubMed  CAS  Google Scholar 

  18. Ohno K, Morotomi Y, Ueda M, Yamada H, Shiokawa C, Nakaoka T, Tsujimoto K, Nakahira M, Moriuchi T, Harumoto K, Yoshida T. Comparison of the Nuss procedure for pectus excavatum by age and uncommon complications. Osaka City Med J 2003 December; 49(2): 71–76.

    PubMed  Google Scholar 

  19. Frick SL. Scoliosis in children with anterior chest wall deformities. Chest Surg Clin N Am 2000 May; 10(2): 427–436.

    PubMed  CAS  Google Scholar 

  20. Waters P, Welch K, Micheli LJ, Shamberger R, Hall JE. Scoliosis in children with pectus excavatum and pectus carinatum. J Pediatr Orthop 1989 September; 9(5): 551–556.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Saulius Lukosevicius.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kilda, A., Basevicius, A., Barauskas, V. et al. Radiological assessment of children with pectus excavatum. Indian J Pediatr 74, 143–147 (2007). https://doi.org/10.1007/s12098-007-0007-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-007-0007-0

Key words

Navigation