Overgrowth of costal cartilage is not the etiology of pectus excavatum

Nakaoka, Tatsuo; Uemura, Sadashige; Yoshida, Tatsuyuki; Tanimoto, Terutaka

doi:10.1016/j.jpedsurg.2010.04.018

Cited by 28 publications

(19 citation statements)

References 3 publications

(5 reference statements)

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“…Before undergoing minimally invasive surgical procedure under thoracoscopic guidance, every patient underwent a thorough clinical check and we were unable to find any kind of correlation between histopathological and clinical features, nor found hints in that direction in the literature. Moreover, rib cartilage was evaluated by means of preoperative chest nuclear magnetic resonance: we were not able to find any difference in terms of breadth and length, when compared with healthy controls from the same age group, as reported in previous descriptions (Nakaoka et al, ).…”

Section: Discussionsupporting

confidence: 68%

“…The preferred hypothesis for the development of PE has long been primary overgrowth of costal cartilage (Sweet, ; Fokin et al, ), until Nakaoka et al () measured costal cartilage length on three‐dimensional reconstructions from computerized tomography, in PE patients and control subjects, and found that costal cartilage in PE patients is no longer than in healthy controls.…”

Section: Discussionmentioning

confidence: 99%

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Rib Cartilage Characterization in Patients Affected by Pectus Excavatum

Tocchioni

Ghionzoli

Calosi

et al. 2013

The Anatomical Record

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Pectus excavatum (PE) is the most frequent anterior chest deformity which may be frequently associated with connective tissue disorders. We performed microscopic analyses to better understand cartilage behavior and obtain clues on its pathogenesis. In 37 PE patients, none with Marfan syndrome, we analyzed costal cartilage by light microscopy, immunohistochemistry and transmission electron microscopy. Control tissue specimens were harvested from four patients without any connective tissue disease. In both control and PE patients, chondrocytes were on the average <15 mm in diameter and occupied <10% of tissue volume; in most cases the extracellular matrix was stained by alcian blue, instead of safranin; no difference between PE and control samples was significant. All samples showed an uneven collagen type II immunolabeling both within the cells and pericellular matrix, and occasionally of the territorial matrix. In all cases numerous cells underwent apoptosis accompanied by matrix condensation as shown by electron microscopy. Our results suggest that matrix composition and the cell number and size of costal cartilage are dependent on the subject and not on the disease; the microscopic organization of cartilage is correlated with the stabilization of the defective shape rather than with the onset of the deformity.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Rib Cartilage Characterization in Patients Affected by Pectus Excavatum

Tocchioni

Ghionzoli

Calosi

et al. 2013

The Anatomical Record

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“…The prevailing hypothesis has long been overgrowth of costal cartilage, further intensified during growth spurts, which pushes the sternal body inward. 36,37 This theory was firstly introduced by Sweet in 1944 and many surgeons supported this theory subsequently, 37 as none reported about the length of costal cartilage until Nakaoka 38 . Nakaoka et al .…”

Section: Aetiopathogenesis Of Pectus Excavatummentioning

confidence: 99%

“…Nakaoka et al . measured costal cartilage length in PE patients and healthy controls from reconstructed images of three-dimensional computed tomography, where costal cartilage in PE patients resulted to be not any longer than in healthy controls 38 . Several studies have then focused on histology and biochemistry of costal cartilage, albeit the results to date remain still inconclusive.…”

Section: Aetiopathogenesis Of Pectus Excavatummentioning

confidence: 99%

Pectus Excavatum and Heritable Disorders of the Connective Tissue

et al. 2013

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Pectus excavatum, the most frequent congenital chest wall deformity, may be rarely observed as a sole deformity or as a sign of an underlying connective tissue disorder. To date, only few studies have described correlations between this deformity and heritable connective tissue disorders such as Marfan, Ehlers-Danlos, Poland, MASS (Mitral valve prolapse, not progressive Aortic enlargement, Skeletal and Skin alterations) phenotype among others. When concurring with connective tissue disorder, cardiopulmonary and vascular involvement may be associated to the thoracic defect. Ruling out the concomitance of pectus excavatum and connective tissue disorders, therefore, may have a direct implication both on surgical outcome and long term prognosis. In this review we focused on biological bases of connective tissue disorders which may be relevant to the pathogenesis of pectus excavatum, portraying surgical and clinical implication of their concurrence.

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“…В то же время T. Nakaoka и соавт. [48] при использовании аналогичного метода показали отсутствие различий в длине реберного хряща как на стороне наибольшего поражения, так и на противоположной стороне у больных с асимметричной формой КД и между ними и лицами без деформации.…”

Section: архив патологии 5 2017unclassified

Costal cartilage structural and functional changes in children with a funnel or keeled chest

Kurkov

Shekhter

2017

Arkh. patol.

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Congenital chest wall deformities (CCWDs) in children are severe diseases leading to cosmetic defects and diseases of the respiratory and cardiovascular systems. The most common of these deformities are funnel-shaped (pectus excavatum, FD) and keeled (pectus carinatum, KD) ones. The pathogenesis of CCWDs and the role of costal cartilage structural and functional changes in their pathogenesis have now been not well studied, which makes it difficult to elaborate pathogenetic approaches to correcting these diseases. Analysis of the literature has shown that structural and functional changes occur in the matrix and chondrocytes from the costal cartilage in FD. Similar costal cartilage changes are observed in KD. It is still unknown exactly which pathological processes are present in the costal cartilage and how they result in the development of one or other type of CCWDs. The role of amianthoid transformation (AT) of costal cartilages in these processes is also unknown. It is not improbable that it is AT drastically changing the native cartilage matrix, which is one of the key mechanisms leading to changes in its properties and to the subsequent development of FD or KD.

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Overgrowth of costal cartilage is not the etiology of pectus excavatum

Cited by 28 publications

References 3 publications

Rib Cartilage Characterization in Patients Affected by Pectus Excavatum

Rib Cartilage Characterization in Patients Affected by Pectus Excavatum

Pectus Excavatum and Heritable Disorders of the Connective Tissue

Costal cartilage structural and functional changes in children with a funnel or keeled chest

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