Funnel chest

Definition:

Congenital malformation of the anterior chest wall that intensifies markedly during puberty and displaces thoracic organs.

  • Functional impairment as well as psychological distress sometimes exist.

     

    Symptoms:

    • Psychological problems
    • Shortness of breath
    • Heart problems
    • Limited physical capacities
    • Scoliosis (spine curves sideways)
    • Occasionally combined with syndromes (Marfan’s)

     

    Diagnostics:

    • Clinical examination
    • Echocardiography (heart ultrasound)
    • Electrocardiogram (EKG)
    • Spirometry (Lung function test)
    • Ear-nose-throat examination
    • Computer tomogram of the chest (selected cross-sections)
    • Chest x-ray examination

     

    Required treatment/conservative treatment:

    The operation is seldom justifiable on purely physical grounds.  The psychological distress,  which we can lessen by operating, is more immediately compelling.  Improved appearance leads to a different body image, boosting self-confidence. Supplemental physical therapy and recommended athletic exercises improve overall posture and appearance.

     

    Operation:

    An exactly curved convex steel bar is surgically  placed under the sternum using a minimally invasive technique under a thoracoscope. By flipping the bar into a concave position the deformity is effectively "dented out". After that, the bar is attached to the chest musculature from outside. During the next 2 - 3 years, the bar stabilizes the throrax and prevents a funnel relapse. The entire thorax is reshaped during this time.

     

    Results:

    Especially when it comes to symmetrical shapes, good corrections can be achieved using these surgical procedures. The scars left by the correction on the lateral thorax are easy to mask.

     

    Frequently asked questions:

    How safe is the operation? - The procedure was developed by an American, D. Nuss, in 1987. It has been performed in Germany for more than 10 years. Given the visual monitoring, injuries to the heart, lung and blood vessels can be avoided.

    At what age is it best to operate? - Around the age of 12, the elastic thorax responds well to stabilization. Premature corrections done before the pubescence growth spurt can set off a recurrence (relapse).  Children older than 12 years can also be operated on. When the funnel chest already exists, you should bring your child in soon, so that we can develop an individualized plan of how best to proceed.

    How long is the stabilizing bar left in the chest? - About 2-3 years.

    Will it be painful for my child? - We work very closely with the pediatric anesthesiologists (anesthetists) . Your child is given a pain catheter before having the anesthetic administered that it can activate independently if it feels pain.

    What about physical therapy? - Physical and respiratory therapy are begun already before the operation.

    How long does the operation take? - About 1 hour, or longer if the findings are exceptional.

    When can my child engage in sports again? - The metal bar is firmly healed in after about 3 months, after which athletic activity can be resumed. But we advise against martial arts.

     

    Contact:

    Clinic and Polyclinic for Pediatric Surgery
    Phone: 03834 - 86 7037
    Fax: 03834 - 86 7038
    Email:kinderchirurgie@uni-greifswald.de

     

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