Pectus excavatum is a chest wall shape in which the breastbone and adjoining rib cartilages sink inwards, creating a hollow in the front of the chest. It is the most common chest wall deformity and is several times more frequent in boys.
It is often visible in early childhood and deepens during the teenage growth spurt. Mild forms are purely a matter of appearance. Deeper forms can press on the heart and limit exercise capacity, and correction can improve both shape and stamina.
Symptome
- A visible dip in the centre or to one side of the chest
- Flared lower ribs and rounded shoulders
- Breathlessness or early tiredness on exertion
- Chest pain or palpitations with exercise
- Self-consciousness, avoiding swimming or changing rooms
Ursachen und Risikofaktoren
The rib cartilages overgrow and push the breastbone backwards. Why this happens is unknown. About four in ten patients have a relative with a chest wall deformity. It is more common with Marfan syndrome, Ehlers-Danlos syndrome and scoliosis, so tall, flexible patients are usually checked for these. It is not caused by posture, injury or vitamin deficiency.
Wie es diagnostiziert wird
- Examination and photographs: Record depth, symmetry and posture.
- CT or MRI of the chest: Used to calculate the Haller index. A value above about 3.25 indicates a significant deformity.
- Echocardiogram: Looks for compression of the right side of the heart and for mitral valve prolapse.
- Lung function and exercise testing: Document any restriction and help decide whether surgery is medically justified.
Behandlungsmöglichkeiten
- Observation and exercise: Posture and strengthening exercises for mild cases. They do not change the bone shape.
- Vacuum bell: A suction cup worn daily for a year or more can lift a shallow, flexible chest, mainly in children and young teenagers.
- Nuss procedure: One or two curved steel or titanium bars are passed behind the breastbone through small side incisions under camera guidance, and removed after two to three years. The ideal age is roughly 12 to 18, though adults are treated too.
- Ravitch procedure: Open removal of abnormal cartilages, used for complex, asymmetric or recurrent deformities.
- Implant or fat grafting: A custom silicone implant camouflages the hollow in adults with no heart or lung effects. It does not change function.
Wenn es dringend ist
After bar surgery, sudden chest pain, breathlessness, a bar that feels as if it has moved, fever or wound discharge need urgent assessment, locally if you are already home. Fainting or palpitations during exercise before treatment should be checked promptly.
Reisen nach Türkiye zur Behandlung
The Nuss operation is planned surgery and travel is feasible: four to six nights in hospital, mostly for pain control, and about two weeks before flying. Bear in mind that the bars must be removed two to three years later, ideally by the same team, and that contact sports are restricted for the first few months. Carry a document describing the implant for airport security and future medical care.
Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.
Häufig gestellte Fragen
Is the Nuss operation very painful?
The first days are. Techniques such as freezing the intercostal nerves (cryoablation) have reduced this considerably.
Am I too old at 30?
No, adults can be corrected, though the chest is stiffer, two or three bars are often needed and recovery is slower.
Will my exercise capacity improve?
Many patients with a deep deformity report better stamina. Those with mild deformities notice little change.
Can it come back after bar removal?
Recurrence is uncommon when bars stay in for the recommended period.