Chest wall deformities are structural abnormalities affecting the ribs and sternum and can have can have significant physical and psychological impacts. These deformities can range from mild to severe, and can impact both physical appearance and, in more severe cases, respiratory function. There are several types of chest wall deformities.
Pectus excavatum (sunken chest): is commonest of the 2 types and is characterised by a concave, sunken appearance of the chest wall, often becoming more pronounced during adolescence.
Pectus carinatum (pigeon chest): on the other hand, involves a protrusion of the sternum and ribs.
These conditions can be congenital (present at birth) or can develop during childhood. The exact cause of chest wall deformities is unknown, but they are believed to be influenced by genetic factors, as they often run in families. They can also be associated with certain syndromes, such as Marfan syndrome and Ehlers-Danlos syndrome.
Symptoms vary depending on the severity of the deformity. In mild cases, individuals might experience no physical symptoms, and the primary concern is related to appearance and self-esteem. However, in more severe cases, the deformity can compress the heart and lungs, leading to physical symptoms like chest pain, respiratory difficulties, and reduced exercise tolerance.
Diagnosis is made through physical examination and imaging studies, such as chest X-rays, CT scans, MRI, echocardiograms and lung function tests. Treatment options vary based on the severity and type of deformity. Mild cases, can be treated with physical therapy and exercises. In severe cases, surgical intervention is recommended. The most common surgical procedure for pectus excavatum is the Nuss procedure, which involves placing a curved metal bar under the sternum to correct the depression. Alternatively, the pectus carinatum can be dealt with Ravitch procedure.
For pectus carinatum, bracing can be very effective, but surgery is also an option.
