Is Pectus Carinatum A Progressive Disease & Alternative Treatments For It?

Medical studies have shown most patients develop pectus carinatum at the time of birth, but the disease shows asignificant progression of the deformity during the growth spurt.1.2

As the condition is becoming increasingly common, several patients are looking forward to an effective alternative procedure to treat this deformity.3

Several trials are being conducted to find a new and less invasive procedure to usually treat a benign pathology.4

Is Pectus Carinatum A Progressive Disease?

Pectus anomalies can be classified into three main types keel chest (pectus excavatum)characterized by the forward displacement of the lower breastbone with a maximum deformity in the sternoxiphoidal junction, lateral pectus carinatum characterized by the bilateral depression of the lower costal cartilages, and pigeon chest which is a protrusion of the breastbone and ribs.

Skeletal deformities can arise in childhood and result in incapacitating scoliosis, joint problems, and other related complexities. The exact cause of the condition is unknown but primary theory centers states that unbalanced growth in the costochondral regions due to genetic factors could be the key reason.1

Nearly 43 percent of the patients with pectus carinatum have a family history of the deformity. According to Dawn E. Jaroszewski, M.D., a Professor in the Department of Cardiothoracic Surgery at Mayo Clinic in Arizona, pectus deformities are not just cosmetic considerations instead it may also lead to cardiac compression and cardiopulmonary impairment.

Although most conditions occur at the time of birth, yet significant developments and progression of the deformity are noticed during the growth spurt in the adolescent stage. This is often accompanied by rapid deformity or worsening of the symptoms.

Pectus malformations typically turn very acute during adolescent growth years and may worsen throughout adult life. Several symptoms may worsen with the advancement in age. The psychological issues associated with a distortion in the appearance can be potential particularly in teens and young adults.2

Alternative Treatments For Pectus Carinatum

Evaluation of the condition is tailored based on the symptoms. The main symptom is psychological. Pectus carinatum patients typically lack confidence, want to isolate themselves, and are embarrassed to undress in public places.

To hide their deformity, they push their shoulders forward while arching their back, however doing so, becomes a permanent postural feature. Pectus carinatum can be treated either through surgical or non-surgical methods. Bracing for the external compression of the sternum is the typical non-surgical method and perhaps the first line of treatment.3

With continuing, clinical expertise and patient feedback, non-surgical and minimally invasive Chest Compressor Braces were developed. Designed with a two-point compressive pressure system by applying pressure over areas of the skeleton to re-align the sternum and cartilages and restore symmetry to the chest.

The vacuum bell can be an effective non-invasive option for lifting the sternum, thus correcting pectus excavatum. This is a safe therapy with few complications reported.4

Musculoskeletal disorders are rare deformities occurring at the time of birth during infancy. Although a birth defect, the significant progression of the condition happens during adolescence when there is a growth spurt. The abnormal prominence is majorly seen in the sternum and its adjacent rib cartilages.

Pectus excavatum is the most common chest wall abnormality and next is the pectus carinatum that accounts for 5% of all chest wall abnormalities. Clinical theories have shown that this anomaly is noticed in 1.7% of school-age children.

References:

  1. “Pectus Carinatum (Concept Id: C0158731) – MedGen – NCBI.” National Center for Biotechnology Information, U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/medgen/57643.
  2. Abid, Irfaan, et al. “Pectus Excavatum: A Review of Diagnosis and Current Treatment Options.” The Journal of the American Osteopathic Association, American Osteopathic Association, 1 Feb. 2017, jaoa.org/article.aspx?articleid=2599969.
  3. Rimessi, Arianna, et al. “Therapeutical Options in Pectus Carinatum in Young Patients.” Pediatric Medicine, AME Publishing Company, 25 May 2019, pm.amegroups.com/article/view/4840/html.
  4. Haecker, Frank-Martin, and Sergio Sesia. “Non-Surgical Treatment of Pectus Excavatum.” Journal of Visualized Surgery, AME Publishing Company, 23 Mar. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5638434/.

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