What Leads To Pectus Carinatum & Can It Be Cured?

Research scientists are conducting clinical trials to identify the cause that leads to pectus carinatum however the exact triggering agent remains unknown.1

Certain studies demonstrate that it occurs because of the cartilage tissue disorder that is connecting the ribs and the breastbone.2

Pectus has an excellent prognosis with the use of a brace, mild to moderate conditions can be treated through bracing whereas severe conditions can be repaired through surgery.3, 4

What Leads To Pectus Carinatum?

The cause of pectus carinatum is not known and doctors cannot determine why some babies are born with pectus carinatum. But this malformation may occur alone or along with other genetic disorders such as Marfan syndrome or Ehler’s-Danlos syndrome, which affect connective tissue in the body that causes the sternum to protrude.

The deformity presents later in adolescence than pectus excavatum and becomes more serious as the child enters puberty stage. The pectus deformities typically impact the child’s self-image and self-confidence.1

Some of the factors apart from Marfan syndrome and Morquio syndrome that lead to pectus carinatum include:

Trisomy 18 & Trisomy 21– There are several clinical trials about the sternal defects and some reported cases of the syndromic short sternum that causes the chest to protrude over the sternum.

Homocystinuria– A genetic disorder that occurs due to CBS deficiency that affects the metabolism of the amino acid methionine which is a building block of lives. These patients have a marfanoid syndrome and protrusion of the sternum.

Multiple Lentigines Syndrome– This is also called Noonan syndrome having a characteristic of the sunken or protruding chest.

Osteogenesis Imperfecta– The condition is a rare connective tissue and a genetic disorder that makes the bone very fragile and brittle resulting in an increased risk of bone fracture and others.2

Can Pectus Carinatum Be Cured?

In mild cases without symptoms, no treatment may be needed. However, with unusual anatomy pectus carinatum can be cured by both surgical and non-surgical methods. The non-surgical method involves the use of a brace. Bracing is most effective in children with mild or moderate pigeon chest and with flexible chest walls.

This technique offers a permanent correction and provides an excellent prognosis in young children. That flexibility means children’s chests can more easily be shaped into the correct structure as they grow. The brace is effective and safe when used properly and only a very few complications are involved.

Pectus carinatum can also be repaired in adults with low morbidity and good aesthetic results. Ravitch procedure is the conventional method of repairing pectus carinatum and it has a long-term result. Minimally invasive repair of pectus carinatum involves the removal of abnormal rib cartilages and leave behind the reliability of the chest wall unaffected. Also, clinical theories state that it is prudent with a short operational period and a hospital stay of 4-6 days. Also, it provides significant outcomes, even in asymmetric cases.

However, with the advancement in the minimally invasive repair technology, the Nuss procedure has a strong demand that used a bar for the correction of chest deformity. The postoperative appearance of the chest was excellent.3,4

Pectus carinatum is a chest deformity where the chest bone sticks out inappropriately. The condition is also called pigeon chest or bird’s chest depending on its posture and the protrusion of the breastbone. Research states that pectus deformities fall under congenital birth defects where there is an abnormal growth of cartilages on the ribs.

References:

  1. “Chest Wall Tumors and Defects.” MedStar Washington Hospital Center, Everything You Should Know About Pectus Carinatum, www.medstarwashington.org/our-services/thoracic-surgery/conditions/chest-wall-tumors-and-defects/
  2. Winkens, Ron, et al. “Pectus Excavatum, Not Always as Harmless as It Seems.” BMJ Case Reports, BMJ Publishing Group, 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3029481/
  3. “Pectus Carinatum.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Oct. 2019, Treatment and Symptoms in Kids over time, www.mayoclinic.org/diseases-conditions/pectus-carinatum/diagnosis-treatment/
  4. Hyperarts, Rob Mayfield -. “Pectus Carinatum.” Department of Surgery – Pectus Carinatum, Effect of the compressive brace in pectus carinatum surgery.ucsf.edu/conditions–procedures/pectus-carinatum.aspx

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