What Are The Ways To Prevent Pectus Carinatum & Does It Reoccur?

Surgical treatment is often done via an incision in the middle chest area to remove the protruding cartilages and to push the breastbone inward.1

Bracing is another effective method that works a similar way as braces work on teeth to put pressure on the breast to make it come back to its normal position.2

Medical studies state that pectus excavatum recurs despite bracing and surgical techniques however the cause of recurrence may differ based on the procedure.3

What Are The Ways To Prevent Pectus Carinatum?

Pectus malformation is classified into two types.

  1. Pectus Excavatum- Also called as “Hollowed Chest” a malformation of the rib cage that provides an appearance of a sunken chest.
  2. Pectus Carinatum- This is referred to as “Pigeon Chest” a rare deformity wherein the breastbone is protruding outwards.

Mild pectus carinatum often doesn’t require treatment nor affect the heart and lung functionalities. However, in some cases, the condition becomes much noticeable affecting the person’s image and produces serious health problems. During such instances, the patient may require treatment to enhance physical and emotional well-being. When patient encounter symptoms, there are two treatment options.1

Bracing For Pectus Carinatum: The classical method of approach for pectus carinatum is bracing. The prognosis for kids with pectus carinatum is outstanding with the use of a chest brace when compared to adults. The primary purpose of bracing is to apply pressure on the affected cartilages to help flatten the protruding rib bones.

Surgery For Pectus Carinatum: When bracing is not an option, positive outcomes can be achieved through surgery. The standard procedure for surgical repair of chest deformities was defined by Ravitch that involves an incision in the mid-chest area to remove the elevated breastbone with two stainless steel struts.

Also, physical therapy has a significant part in treating pectus carinatum they are used as a part of the bracing program or sometimes post-operatively after a Ravitch procedure.2

Does Pectus Carinatum Reoccur?

The recurrence of pectus excavatum is one of the vital complications noticed in the clinical studies. Theories demonstrate the characteristics of chest wall depression that occurs during treatment increase the risk factors for the recurrence of the condition. However, the causes of recurrence differed based on the initial procedure performed to resolve the appearance. This included incomplete previous repair, a procedure performed at a very young age, deeper incision, incorrect removal of cartilages, and chest wall not healing properly.

However, another study shows that Ravitch and Nuss’s procedures have excellent results, and patients who underwent these procedures have expressed utmost satisfaction about their appearance and recovery post-surgery. The recurrence rate was less than 1 percent in several patients.

Children can be braced in the early years through adolescence for better results. Children in the younger age often respond faster than teenagers but the braces should be worn throughout day and night for several months and perhaps followed especially during puberty to avoid recurrence.3

Pectus is nothing but a chest wall that is made up of muscles and bone fragments protected by skin. They protect major organs like the heart, blood vessels from serious injuries and helps with breathing. Pectus carinatum is a condition wherein the breastbone is pushed outwards.

This condition occurs most commonly in children and young adults. In some instances, both their ribcages are affected, and, in some children, it is asymmetrical on one side affecting one in 1500 children.

References:

  1. Fonkalsrud, Eric W, et al. “Repair of Pectus Excavatum and Carinatum Deformities in 116 Adults.” Annals of Surgery, U.S. National Library of Medicine, Sept. 2002, www.ncbi.nlm.nih.gov/pmc/articles/PMC1422584/.
  2. Fraser, Stephanie, et al. “Pectus Updates and Special Considerations in Marfan Syndrome.” Pediatric Reports, PAGEPress Scientific Publications, Pavia, Italy, 4 Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5768089/.
  3. Jaroszewski, Dawn E, et al. “Revision of Failed, Recurrent or Complicated Pectus Excavatum after Nuss, Ravitch or Cardiac Surgery.” Journal of Visualized Surgery, AME Publishing Company, 5 Apr. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5638036/.

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