Chest Wall Deformity: Pectus Excavatum
Pectus excavatum, otherwise known as sunken or funnel chest, is a birth anomaly of the chest wall. In this defect, several ribs and the sternum grow inward and produce a caved-in look of the chest wall.
Of all congenital chest wall defects, pectus excavatum is the most common, appearing in 90% of those with a chest wall abnormality. Other deformities of the chest wall include pectus carinatum, cleft sternum, pentalogy of Cantrell, asphyxiating thoracic dystrophy, and spondylothoracic dysplasia. The condition is normally noticed at birth; however, the chest’s appearance will worsen as bone development, particularly in the teen years, grows rapidly.
Pectus excavatum occurs predominantly in males, and is estimated to occur in approximately 1 in 400 births. Self-esteem issues are frequently experienced with those born with pectus excavatum, particularly in teen patients.
Cause and Description
In this condition, 4 to 5 ribs on both sides of the sternum are typically affected, as the growth of the cartilage and bone grows abnormally in the chest wall. In addition, the abnormality can be quite asymmetrical, with the right and left sides differing. Unfortunately, the reason why the bone and cartilage grows abnormally is not understood, and no known genetic defect has been found as the cause of pectus excavatum. For reasons also not yet known, this condition is associated with Marfan syndrome (a condition in which the connective tissue is defective and does not function as it should) and Poland’s syndrome (a malformation on one side of the chest wall).
Symptoms associated with pectus excavatum include the inability to take deep breaths, shortness of breath, pain in the anterior chest wall, and lack of stamina during any exertion. A variety of respiratory complications are also experienced. Anxiety and other emotional problems can also surface in those with pectus excavatum, including loss of motivation and exhibiting feelings of low self-esteem.
Reconstructive surgery of the chest wall is an option for correcting pectus excavatum. The results of such operations are very successful and can help to give the patient a certain quality of life that he or she did not possess before. Not only does the patient experience an immediate raise in their self-esteem, but the physical improvements in breathing and stamina are immeasurable. Most individuals report an increase in ability to engage in sports and hobbies and have been able to enjoy strenuous activities that they could not in the past.
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