Treatments for Chest Wall Deformities in Children

How are chest wall deformities treated?

For mild cases of either condition, there's really no reason for intervention.

  • A shallow funnel chest is unlikely to affect the operation of the heart or lungs at all.
  • A mild pigeon breast, if anything, gives the thoracic organs more room to function.
  • Appearance, too, is normal in these cases.

What if my child's case is more severe?

Funnel chest

A severe funnel chest can impinge on your child's heart and lungs, but it's important not to overstate the risks.

  • At extremes of exercise, there is a slight deficit in the volume of blood the heart can pump out with each beat. That's because the heart has less room to fill when it relaxes.
  • Pulmonary function tests also show a slight deficit in severe cases of funnel chest. But again, this occurs only at extremes of exercise.

These children are not at any elevated risk for sudden death.

Pigeon breast

With severe cases of pigeon breast, the problem is one of form rather than physiology.

Some children with severe conditions are perfectly content with the shape of their chests. But those who suffer psychologically can suffer deeply.

What are our treatment options?

Funnel chest

Funnel chest can be surgically repaired. There are two options:

The Welsh - The surgeon makes an incision in your child's chest wall, removes the cartilage wedged between the ribs and breastbone, and then repositions the freed-up breastbone.

  • A bar is left in the chest wall to maintain the right shape for six months, during which time the child has to refrain from activities that might involve a collision, like football.
  • The technique leaves a scar visible on the chest, but fixes the problem.

The Nuss - The incisions are made on the side, a bar is inserted laterally through the chest and the breastbone is lifted forward.

  • No cartilage is removed.
  • Scarring is less extensive.

On the other hand, any asymmetry that's there before the operation will remain to some degree. And there's just as much pain throughout recovery. Also, the bar has to stay in for at least a year, and sometimes two. Surgeons at Children's specialize in both techniques.

Pigeon breast

As for fixing a severe pigeon breast, doctors at Children's recommend bracing, as pressure over time reforms the chest wall.