Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients

Nakaoka, Tatsuo; Uemura, Sadashige; Yano, Tsunehiro; Nakagawa, Yoshikiyo; Tanimoto, Terutaka; Suehiro, Shigefumi

doi:10.1016/j.jpedsurg.2008.09.023

Cited by 38 publications

(21 citation statements)

References 6 publications

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“…This is the origin of the overgrowth theory of PE. However, Sweet [2] did not measure the length of costal cartilage, but many pediatric surgeons have believed this overgrowth theory.In our previous study [3], we reported that, in asymmetric PE patients, the right was shorter than the left rib, and the right costal cartilage was also short or did not differ from the left. …”

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confidence: 77%

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Overgrowth of costal cartilage is not the etiology of pectus excavatum

Nakaoka¹,

Uemura²,

Yoshida³

et al. 2010

Journal of Pediatric Surgery

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confidence: 77%

“…In our previous study [3], we reported that, in asymmetric PE patients, the right was shorter than the left rib, and the right costal cartilage was also short or did not differ from the left.…”

mentioning

confidence: 77%

Overgrowth of costal cartilage is not the etiology of pectus excavatum

Nakaoka¹,

Uemura²,

Yoshida³

et al. 2010

Journal of Pediatric Surgery

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“…ASR was measured by using the chest CT image; a slice depicting the sharpest sternal twist was selected. The angle was defined as the sternal slope against the baseline, connecting the left and right dorsal ends of the thorax 6) (Fig. 1).…”

Section: Height and Weightmentioning

confidence: 99%

“…This new approach was designed to improve functional and cosmetic outcomes, and it has gained acceptance worldwide as the new standard of care procedure. 3,4) The morphological results of pectus excavatum correction, in terms of improvement in depression or asymmetry, can be evaluated by the Haller computed tomographic index (CTI) 5) or the asymmetric index (AI) and the angle of sternal rotation (ASR) 6,7) as objective radiographic markers.…”

Section: Introductionmentioning

confidence: 99%

Effect of the Nuss Procedure on the Physical Development of Patients with Pectus Excavatum

Kim

Yoon

Han

et al. 2016

ATCS

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Purpose: This study assessed physical development of patients with pectus excavatum and evaluated the effect of the Nuss procedure on physical development. Methods: A total of 146 patients underwent the Nuss procedure; of these, at the time of the study, the bar had been removed from 123 patients (84.9%; male 93, female 30) who were eligible for participation in this study. Heights and body weights of patients were measured prior to surgery and immediately before bar removal. Chest computed tomography (CT) was performed preoperatively and immediately before bar removal. The associations between physical development and chest CT indices were evaluated. Results: The height standard deviation score (SDS) was − 0.66 ± 2.23 preoperatively and 0.04 ± 1.34 immediately before bar removal (p <0.01). The weight SDS was − 0.02 ± 2.59 preoperatively; it increased significantly to 0.56 ± 1.56 immediately before bar removal (p <0.01). The Haller index (3.85 ± 1.18 to 2.99 ± 0.54; p <0.01) and asymmetric index (9.75 ± 6.63 to 7.01 ± 4.77; p <0.01) also showed improvements. Conclusions: The Nuss procedure may contribute positively to the physical development of patients with pectus excavatum.

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“…Several theories explain the cause of pectus excavatum, but the aetiology remains obscure. Some authors believe that pectus excavatum may be due to overgrowth of costal cartilage, which displaces the sternum posteriorly [2][3][4]. Other theories are that abnormalities of diaphragm, rickets, elevated intrauterine pressure or intrauterine compression to the sternum cause posterior displacement of the sternum [4].…”

Section: Introductionmentioning

confidence: 99%

Surgical correction of the funnel chest deformity in children

Žganjer

2010

International Orthopaedics (SICOT)

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The aim of this study was to evaluate our results during and after the Nuss operation in children with pectus excavatum. We have performed the Nuss procedure in 128 patients with pectus excavatum since 2001, and 74 patients underwent bar removal. Of the 128 patients 96 were male and 32 were female; age ranged from eight to 21 years with an average of 13.8 years. In 46% of patients psychological reasons for operative treatment were dominant while in the other 54% of patients clinical signs were the indications. Complications in 128 patients included 36 pneumothorax, 28 of which resolved spontaneously. Postoperative pneumonia developed in six patients. In two patients we had infection of the implanted bar, and there were two patients with cellulitis. We had six patients with bar displacement and reoperation was needed. During the Nuss procedure we had one injury of the intercostal artery. We had pericardial tears in two patients without clinical significance. In two patients we had pericardial effusion six months after the Nuss procedure, requiring pericardiocentesis. In one patient we had fracture of the sternum. There were no complications following bar removal. After bar removal in 74 patients, 54 patients (72.9%) maintained excellent results with normal chest anatomy, good results were found in 16 patients (21.6%) with mild residual pectus and poor results in four patients (5.5%) with severe recurrence. Our experience with the Nuss procedure demonstrated excellent results with few minor complications.

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Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients

Cited by 38 publications

References 6 publications

Overgrowth of costal cartilage is not the etiology of pectus excavatum

Overgrowth of costal cartilage is not the etiology of pectus excavatum

Effect of the Nuss Procedure on the Physical Development of Patients with Pectus Excavatum

Surgical correction of the funnel chest deformity in children

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