Pectus Excavatum | Diagnosis and Treatment

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How is pectus excavatum diagnosed?

Pectus excavatum is usually diagnosed with a physical examination. X-rays of the chest can be helpful, as well.

Other tests your child's doctor might recommend include:

What are the treatment options for pectus excavatum?

For mild cases of pectus excavatum, there's really no reason for surgery. A shallow excavatum is unlikely to affect the heart or lung functioning, and your child's appearance will remain normal.

If the deformity is causing physical or social problems, it can be surgically repaired. There are two options, both of which require your child to be put under general anesthesia:

Ravitch

In this procedure, the surgeon makes an incision in your child's chest wall, removes the cartilage wedged between the ribs and breastbone and repositions the freed-up breastbone. A bar is left in the chest wall to maintain the correct shape for six months, during which time your child has to refrain from activities that might involve a collision, like football. The technique fixes the problem but leaves a scar visible on the chest.

Nuss

In this procedure, the incisions are made on the side of your child's chest wall. Then the surgeon inserts a bar laterally through the chest and moves the breastbone forward. No cartilage is removed, and scarring is less extensive.

The Nuss procedure doesn't remove any asymmetry in the way your child's chest looks. The bar has to stay in for at least one year, and sometimes two.

What are the benefits of repairing my child's excavatum?

While most children with pectus excavatum don’t need any treatment at all, more severe cases can be surgically repaired, allowing your child to lead a normal, active life.

In severe cases, repair of a pectus excavatum may help the function of the heart and lungs. But in most cases, the benefits are mostly psychological. For children who have been upset by their appearance, the surgery can make a big difference.

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