Pectus carinatum is an uncommon birth defect that involves deformity of the chest. It is portrayed by the abnormal outward protrusion of the sternum and ribs. In some cases, the deformity isn't noticeable until after the adolescent growth spurt. Although pectus carinatum sometimes interferes with an individual’s overall health, most individuals generally develop normal heart and lung function.
In most cases of children and young adults with pectus carinatum, the greatest challenge lies with living with the deformity. The shape of the chest can damage an individual’s self image and self confidence, in turn resulting in social withdrawal.
The recommended treatment option for children suffering from pectus carinatum is wearing a brace that can help flatten the chest and prevent interference with growing bones. In cases of severe pectus carinatum, surgical repair is a recommended option.
Signs and symptoms of pectus carinatum include:
- Outward position of the chest wall
- Pain and tenderness in the area of overgrown cartilages
- Shortness of breath
- Mild to moderate asthma
- Psychological changes (mood swings, feeling uncomfortable in one’s skin, social withdrawal)
Although the exact cause remains known, pectus carinatum tends to recur in families suggesting that genetics may play a role. It is the result of a birth defect that causes the cartilage to overgrow, in turn causing the sternum to protrude forward. Pectus carinatum may occur as a solitary abnormality or in association with other genetic disorders or syndromes. These syndromes may include:
· Turner syndrome
· Noonan syndrome
· Marfan syndrome
· Ehlers-Danlos syndrome
· Morquio syndrome
· Multiple lentigines syndrome
· Sly syndrome
· Trisomy 18
· Trisomy 21
· Osteogenesis imperfect
Treatment options for Pectus carinatum typically depend on the age of the individual in question, their overall health and the overall severity of their condition.
In children up to the age of 18 who have mild to moderate pectus carinatum, the recommended treatment option is bracing of the chest wall.
· Bracing: A procedure that involves custom fitting of a circumferential external brace that puts directed pressure on the sternum or cartilages in order to flatten the chest wall. Adjustments may be needed as the child grows and the pectus improves. The brace must be worn all throughout the day and night and regular supervision is required in order to provide positive end results.
In individuals with severe pectus carinatum, surgery may be recommended as treatment option.
· Ravitch technique: A surgical procedure that involves an incision to the chest, removal of the abnormal cartilage and detachment of the sternum. A small bar is further inserted beneath the sternum to hold it in an appropriate position until the cartilage grows back, on average in about 6 months.
· The Nuss technique: A less invasive surgical procedure that involves putting one or more concave steel bars into the chest, beneath the sternum. The bar is adjusted as to push outward on the sternum in order to correct the deformity. The bar usually stays in the body for about two years until the bones have hardened into place.
After adolescence, some individuals may choose bodybuilding as a way to hide deformity. Bodybuilding is suggested for individuals with symmetrical pectus carinatum.