Chest Wall Deformities: An Overview on Classification and Surgical Options

Torre, Michele; Rapuzzi, G; Jasonni, Vincenzo; Varela, Patricio

doi:10.5772/25950

Cited by 7 publications

(4 citation statements)

References 87 publications

(113 reference statements)

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“…Practically, the visual description of these deformities as either mild, moderate or severe ( Figure 1 ), is most commonly in use, however, detailed classification systems of chest wall abnormalities exist. 5 Whilst the severity of the deformity does not necessarily imply that the patient will be more symptomatic, classification can be useful in communication between healthcare professionals and in decision-making regarding operative approach.…”

Section: Introductionmentioning

confidence: 99%

Pectus Updates and Special Considerations in Marfan Syndrome

2018

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Congenital chest wall or pectus deformities including pectus excavatum (funnel chest) and pectus carinatum (pigeon chest) affect a significant proportion of the general population and up to 70% of patients with Marfan syndrome. Patients often experience significant morbidity and psychological distress, which can worsen with age. Here we discuss new techniques for both operative and non-operative treatment of pectus deformity, the importance of a welltimed intervention and special considerations in patients with Marfan syndrome.

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Section: Introductionmentioning

confidence: 99%

Pectus Updates and Special Considerations in Marfan Syndrome

2018

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“…19 According to Torre et al, the cardiopulmonary function is also limited in pigeon chest patients, although not as much as in funnel chest patients. 20 Even if the respiratory excursion is limited in pigeon chest patients, the resulting symptoms are only mild according to Robicsek et al 21 Fonkalsrud also observed a decreased respiratory excursion, which leads into an increased residual capacity. However, during physical stress, there is an increased respiratory rate that can compensate for the increased residual capacity.…”

Section: Discussionmentioning

confidence: 99%

Symptoms in Pectus Deformities: A Scoring System for Subjective Physical Complaints

Ewert

Syed

Kern

et al. 2016

Thorac cardiovasc Surg

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The literature is silent on the relationship between symptoms and the Haller index. Nor is there a classification of the severity of the physical complaints. Retrospectively, data from 128 patients (102 funnel, 25 pigeon chest patients, and 1 mixed type) were evaluated. To objectify the symptoms, we developed a score to describe the level of physical ailments. This score includes 10 different symptoms as well as the situation or frequency in which they occur and an impact factor. This depends on how much they affect everyday life. Pectus excavatum patients express physical complaints more frequently than pectus carinatum patients who actually suffer more from psychological stress. We could not find a correlation between the Haller index and symptoms or levels of ailment. Pectus deformities are likely to cause physical and psychological complaints. Since the subjective symptoms did not show any correlation to the chest severity index, they are supposed to be independent from the deformity's extent.

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“…In conclusion, our retrospective results suggest that the surgical correction of CS syndrome be pursued at this time only with the goal of cosmetic improvement, and although patients reported subjective improvement in dyspnea related symptoms, significant objective clinical benefit was not appreciated in the patients studied. The best surgical option remains the relatively aggressive Ravitch-type procedure with multi-level wedge osteotomy (3,23,26,36), allowing for the achievement of a satisfactory outcome, including a high satisfaction rate in this group of patients. Given the rarity of the deformity, it's surgical correction should be completed by a multidisciplinary team, including thoracic reconstructive surgeons with experience in pectus deformities.…”

Section: Discussionmentioning

confidence: 99%

“…PC is seen less frequently than PE, comprising about 5-15% of patients with pectus abnormalities and occurs in about 1:1,000-1:10,000 of all live births with a male predominance (4:1) (1,2). Some data indicate that milder forms of PC are more frequent, with even greater Original Article Currarino-Silverman syndrome: diagnosis and treatment of rare chest wall deformity, a case series prevalence than PE and ratio of 2:1 (3,4). The etiology of PC is not fully understood, however, the generally accepted theory is that the deformity is secondary to an excessive growth of costal cartilage secondary to genetic factors, which results in a sternal deformity without pathology in the sternum itself (5).…”

Section: Introductionmentioning

confidence: 99%

Currarino-Silverman syndrome: diagnosis and treatment of rare chest wall deformity, a case series

Gritsiuta¹,

Bracken²,

Beebe³

et al. 2021

J Thorac Dis

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Background: Currarino-Silverman (CS) syndrome is an extremely rare congenital deformity of the anterior chest wall. The syndrome is often combined with congenital heart defects and spinal abnormalities. As of currently, there is a lack of definite description in the literature about this type of pectus deformity.Typically, patients do not require surgical intervention for medical reasons, and the correction is usually only for cosmetic purposes. The purpose of this study was to demonstrate surgical intervention for CS syndrome at a tertiary care facility, and to summarize the available literature. Methods: Patients with CS syndrome were retrospectively reviewed from a period of June 2012 to August 2019. An extensive literature search for "Currarino-Silverman syndrome," "pouter pigeon chest," "chondromanubrial deformity," "type 2 pectus carinatum" and "pectus arcuatum" was performed. Results: Four clinical cases of CS syndrome are presented, two of which were symptomatic and corrected.The procedure of choice was the modified Ravitch-type thoracoplasty with double osteotomy and implantation of support plates. Conclusions: There is no clear definition of CS syndrome in the literature. Correct and uniform classification plays a crucial role in the surgical treatment of this pathology. Due to the extreme rarity of the disease, challenging deformity, and variable anatomy of the fused sternum, there are no clear guidelines in treatment approaches. The correction is mostly pursued only for cosmetic results, and the best surgical option for CS syndrome remains the relatively aggressive Ravitch-type procedure with multi-level wedge osteotomy.

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Chest Wall Deformities: An Overview on Classification and Surgical Options

Cited by 7 publications

References 87 publications

Pectus Updates and Special Considerations in Marfan Syndrome

Pectus Updates and Special Considerations in Marfan Syndrome

Symptoms in Pectus Deformities: A Scoring System for Subjective Physical Complaints

Currarino-Silverman syndrome: diagnosis and treatment of rare chest wall deformity, a case series

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