Surgical correction of pectus excavatum using a rib graft strut following excision of costal cartilages

Bhatnagar, Veereshwar; Sharma, Neeraj; Dhua, Anjan Kumar; Jana, Manisha

doi:10.4103/jiaps.jiaps_68_18

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…The treatment options for PE and PC include surgical and non-surgical methods. The surgical approaches vary technically [ 2 , 3 , 9 – 13 ] and one of the most common strategies includes removal of the pathologically changed costal cartilage of the deformed chest. A pathology of the costal cartilage in PE and PC patients is thought to be the cause of mechanical failure of the chest [ 1 , 2 , 6 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Amianthoid transformation of costal cartilage matrix in children with pectus excavatum and pectus carinatum

et al. 2021

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Background It is unclear if amianthoid transformation (AT) of costal cartilage extracellular matrix (ECM) has an impact on the development of pectus excavatum (PE) and pectus carinatum (PC). Methods AT foci were examined in intrasurgical biopsy specimens of costal cartilages of children (8–17 years old) with PE (n = 12) and PC (n = 12) and in age-matching autopsy control samples (n = 10) using histological and immunohistochemical staining, atomic force and nonlinear optical microscopy, transmission and scanning electron microscopy, morphometry and statistics. Results AT areas were identified in the costal cartilage ECM in children with normal chest, PE and PC. Each type of the AT areas (“canonical”, “intertwined”, “fine-fibred” and “intralacunary”) had a unique morphological pattern of thickness and alignment of amianthoid fibers (AFs). AFs were formed via lateral aggregation of collagen type II fibrils in the intact ECM. Foci of the AT were observed significantly more frequently in the PE and PC groups. The AT areas had unique quantitative features in each study group. Conclusion AT is a structurally diverse form of ECM alteration present in healthy and pathological costal cartilage. PE and PC are associated with specific AT disorders.

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Section: Introductionmentioning

confidence: 99%

Amianthoid transformation of costal cartilage matrix in children with pectus excavatum and pectus carinatum

et al. 2021

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“…However, in most cases, long-lasting and safe operative reposition of the sternum is possible with the use of various foreign bodies that have to be removed. The procedures are based on autologous rib grafts or wedge cartilage resections performed on the surfaces of the deformed cartilages, including the aforementioned metal structures and plastic restorations [ 3 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term results after the modified Ravitch procedure performed in children and adolescents – a one-time procedure without the need to use additional support of the sternum. A retrospective study

Buchwald¹,

Ligarski²,

Polewczyk³

2020

kitp

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Introduction Pectus excavatum is a depression of the sternum. Pectus carinatum, in contrast, is the convexity of the sternum. The mixed form is an intermediate condition. Surgical intervention is the treatment of choice. The techniques most commonly used include the Ravitch and the Nuss procedures. Aim To assess the immediate and long-term results of the original modification of the surgical treatment for anterior chest wall deformation. Material and methods The modification is based on the Ravitch procedure. The difference is that the ends of the resected cartilages are shaped like a blade in order to be inserted into the previously prepared wedge-shaped hollows located on both edges of the sternum. The result is long lasting without the need to use additional brackets. Results The follow-up examinations performed in 72 patients, including 57 boys and 15 girls, were the basis to produce long-term results. As for the type of deformity, out of 57 patients operated on due to pectus excavatum, 43 expressed satisfaction with the very good result. Similar satisfaction was reported in 7 out of 11 patients operated on due to pectus carinatum. There were 4 cases with the mixed form who had very good long-term results. Wound dehiscence was observed in 13 subjects, with one documented recurrence. Conclusions The alternative treatment we propose is a one-time procedure without the need to use additional support of the sternum. Good long-term results make the procedure suitable to be used more frequently in all types of deformities.

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Phenotypic features of rib cartilage cells in funnel-shaped chest deformity

Strokova,

Pakhomova,

Shevchenko

et al. 2024

Sibirskij nauchnyj medicinskij zhurnal

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Funnel-shaped deformity of the chest is a serious disease with an unknown etiology and pathogenesis. Pathological changes occurring in the cartilaginous tissue of the ribs are one of the leading mechanisms for the development of chest curvature. Analysis of the phenotypic features of cells isolated from the site of localization of the pathological process will create a more complete picture of the deformation development.Aim of the study was to identify the phenotype of rib cartilage cells in funnel-shaped deformation of the thorax.Material and methods. Rib cartilage cells of children with funnel-shaped chest deformity were cultured up to the 2–3rd passage, then were identified by histochemical and immunohistochemical methods.Results and discussion. The study revealed cells of two different phenotypes. The first type is oval and polygonal chondroblasts expressing a marker of chondrogenic differentiation. The second type is the cells of the neural phenotype with the expression of early neural markers Musashi1 and PAX6 and the neurospecific protein III β-tubulin, as well as the substance Nissl.Conclusions. The analysis of the phenotypic features of rib cartilage cells with funnel-shaped curvature of the chest allowed us to expand the idea of a possible etiological factor in the deformation development.

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Surgical correction of pectus excavatum using a rib graft strut following excision of costal cartilages

Cited by 3 publications

References 18 publications

Amianthoid transformation of costal cartilage matrix in children with pectus excavatum and pectus carinatum

Amianthoid transformation of costal cartilage matrix in children with pectus excavatum and pectus carinatum

Long-term results after the modified Ravitch procedure performed in children and adolescents – a one-time procedure without the need to use additional support of the sternum. A retrospective study

Phenotypic features of rib cartilage cells in funnel-shaped chest deformity

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