How Are Chest Wall Deformities Evaluated?
Differences in the shape of the chest wall can often be noticed during a physical examination. However, when necessary, imaging and functional tests may be used to assess the structure and degree of the deformity.Depending on the person’s age and clinical findings, the evaluation may include tests such as computed tomography (CT), pulmonary function tests, or a cardiac evaluation.
The treatment plan is not the same for every deformity. For some people, follow-up alone may be sufficient, while in other cases conservative methods or surgical treatment options may be considered.
Pectus Excavatum
Pectus excavatum is a chest wall deformity characterized by an inward sinking of the breastbone (sternum) and the front of the chest wall. It is also commonly known as “funnel chest” or “sunken chest.”
The degree of the deformity can vary from person to person. In mild cases, the main finding may be a difference in the appearance of the chest, while in more pronounced deformities, the position of the structures inside the chest and heart-lung function are also evaluated.
The need for treatment is not determined by appearance alone. Age, the degree of the deformity, the growth process, physical complaints, and test results are evaluated together.
Different methods may be used in people for whom surgical treatment is considered appropriate. The choice of method is based on the characteristics of the deformity and the person’s individual anatomy.
Pectus Carinatum
Pectus carinatum is a chest wall deformity in which the breastbone and the front of the chest wall protrude further forward than normal. It may also be called “pigeon chest.”
The deformity may become more pronounced during the rapid growth of childhood and adolescence. Which part of the chest wall is affected and whether the deformity is symmetric can vary from person to person.
In the treatment of pectus carinatum, age, the flexibility of the chest wall, and the degree of the deformity are important. In suitable patients, orthotic brace systems that apply controlled pressure to the chest wall may be considered. Surgical treatment may be considered in selected cases.
The treatment method is determined individually based on the physical examination and an assessment of the chest wall’s characteristics.
Poland Syndrome
Poland syndrome is a congenital developmental difference that usually affects one side of the chest. One of its most characteristic findings is underdevelopment of part or all of the pectoralis major, one of the chest muscles.
The differences in the chest wall may be accompanied by differences in the development of breast tissue, the ribs, or the upper limb on the same side. The extent and severity of the findings can vary considerably from person to person.
For this reason, evaluation and treatment of Poland syndrome are not based on a single standard method.
The degree of structural differences in the chest wall, accompanying anatomical features, and the functional or appearance-related problems the person experiences are evaluated together.
When necessary, treatment planning may require a joint evaluation by thoracic surgery, plastic and reconstructive surgery, and other relevant specialties.
How Is Treatment for Chest Wall Deformities Determined?
Not everyone with a chest wall deformity needs surgery. Depending on the type and severity of the deformity, the treatment approach may include follow-up, conservative methods, or surgical options.In making a decision, not only the appearance of the chest is considered, but also the person’s age, skeletal development, chest wall flexibility, whether the deformity is progressing, physical complaints, and, when necessary, the results of heart and lung evaluations.
Ongoing growth, especially during childhood and adolescence, can affect the appearance of some deformities and the treatment options available. For this reason, the evaluation process is tailored to each individual.