Pectus excavatum

What is pectus excavatum ?

Pectus excavatum, also called “sunken” or “funnel” chest, is the most common congenital deformity of the anterior wall of the chest, in which the sternum (breastbone) and the ribs grow abnormally. It appears as a depression in the middle of the chest and produces a caved-in or sunken appearance of the chest. Pectus excavatum is not rare, one in every 1,000 children has some form of the condition, ranging from mild to severe. It is more common in boys than in girls (male/female-ratio 3:1). Occurrences of the condition in family members have been reported in 35-45 % of cases.

What causes pectus excavatum ?

The condition is caused by excess growth of connective tissue between the ribs and the sternum.

Are children born with pectus excavatum ?

The condition can either be present at birth or not develop until puberty, but it doesn’t affect growth or development. As the children grow, the chest depression often becomes more pronounced and may cause symptoms.

What symptoms does it cause ?

Patients often experience psychological distress and negative body image. They avoid activities that expose the chest. Mild cases may cause no physical symptoms, but deeper depressions of the chest wall may press on the heart and lungs, making it difficult for children to exert themselves. Shortness of breath while exercising is the most common symptom.

How is it treated ?

In the past, pectus excavatum was often considered “merely” a cosmetic issue.

Nearly 20 years of research and experience caring for patients with the condition has changed that perception. Because the deformity can cause both physical and emotional problems for children, we recommend that all cases should be evaluated by a pediatric surgeon.

There are several different options for treatment, including the Vacuum bell as non-invasive technique, the Nuss technique (minimally invasive technique consisting in slipping one or more steel bars underneath the sternum) and the Ravitch technique (invasive procedure consisting in the resection of the cartilage in excess). With our expertise in chest wall deformities, we can help you select the best treatment option for your child based on his or her age and specific needs.

Without treatment, pectus excavatum usually worsens during puberty.