Pectus excavatum, also known as sunken chest or funnel chest, is a chest wall deformity in which the sternum is sunken inward toward the thoracic cavity. It is the most common congenital chest wall deformity.
The Thorax
The thorax is an anatomical region of the axial skeleton, located between the neck and the abdomen. It comprises the rib cage, including the sternum, ribs, and thoracic spine.
Within this cavity lie vital organs, such as the heart, lungs, and major blood vessels, including the aorta and vena cava.
The thorax also contains muscular structures, nerves, and connective tissue that contribute to essential functions such as blood circulation and breathing.
Sunken Chest
Sunken chest occurs due to abnormal development of the cartilage that connects the ribs to the sternum.
The degree of depression can vary. In mild cases, the deformity is mostly cosmetic, but in severe cases, it can compress internal organs.
Functional impact depends on the organ involved:
- Heart compression may reduce its pumping capacity and impair blood circulation.
- Lung compression can limit pulmonary capacity, leading to shortness of breath, especially during physical activity.
Common symptoms of this condition include:
- Chest pain
- Fatigue
- Difficulty breathing
- Palpitations
Beyond its physical impact, pectus excavatum can also have a psychological effect, influencing self-esteem and quality of life, especially during adolescence.
Diagnosis of pectus excavatum involves a physical examination to assess the shape of the chest, along with diagnostic imaging such as:
These help evaluate the depth of the depression and its effect on internal organs.
Functional tests, such as echocardiograms and spirometry, may also be required to assess heart and lung function.
Treatment for Pectus Excavatum
Treatment depends on the severity of the condition and its impact on the patient’s health.
Non-surgical options include:
- Physical therapy exercises to strengthen chest muscles and improve posture.
- Vacuum bell therapy, which gradually elevates the sternum. This is particularly effective in children, as their bones are still flexible.
Surgical options are recommended for moderate to severe cases, especially when there is functional impairment. The two main procedures are:
- Nuss procedure: A minimally invasive approach where one or more curved metal bars are inserted under the sternum to correct the deformity. These are usually removed 2–4 years after surgery.
- Ravitch procedure: A more invasive technique that involves removing deformed cartilage and repositioning the sternum. It is used in complex cases or when the Nuss technique is not suitable.
While most patients experience significant improvements in chest function and appearance, outcomes depend on factors such as:
- Patient’s age
- Severity of the deformity
- Adherence to medical recommendations
Pectus excavatum can affect both physical and emotional health. Early diagnosis and proper management are key to achieving the best possible outcomes.
At the ABC Medical Center’s Pediatric Center, we can provide you with specialized care. Contact us today!
Fuentes
MedlinePlus, Scielo, Cleveland Clinic
