Pectus Excavatum

Pectus excavatum (also known as funnel chest) occurs when the breastbone is sunken into the chest. In severe cases, there is a deep dent in the middle of the chest.

While the sunken breastbone is generally noticeable shortly after birth, the condition typically worsens as the patient grows up, particularly for patients going through puberty.

Pectus excavatum is more commonly found in boys than girls. Severe cases can affect the function of heart and lungs. Additionally, even in mild cases, patients may feel self-conscious about their appearance. However, surgery can successfully correct the deformity.

Some signs and symptoms include:

While the condition can usually be diagnosed by a chest examination, the doctor may order some tests for the patient to check for associated heart and lungs complications. Some of these tests are:

Patients with mild conditions may be treated with physical therapy, whereby certain exercises can help improve posture and increase the degree to which the chest can expand.

Surgical treatment is usually for patients with moderate to severe symptoms. The two most common types of surgeries for pectus excavatum are the large incision and smaller incisions. 

For larger incision, the incision is done in the center of the chest, which allows the surgeon to directly view the breastbone. The surgeon will then remove the deformed cartilage attached to the ribs and lower breastbone, allowing the breastbone to be fixed into a more normal position, with the help of surgical hardware such as a metal strut or mesh supports. These supports can be removed in 12 months.

With smaller incisions, the procedure is minimally invasive, whereby small incisions are placed under each arm on each side of the chest. A narrow fiber-optic camera and long-handled tools are inserted through the incisions. Next, one or more curved metal bars are threaded under the dented breastbone, raising the breastbone into a more normal position. The bars can be removed after two years.

Regardless of the procedure used, many patients who have undergone corrective surgery are satisfied with the results. The best results can be achieved when the procedure is performed for patients going through their growth spurt at puberty. However, many adults have also benefitted from the pectus excavatum repair surgery.