Chest Wall Disorders
Chest wall deformities in children can affect both the health of a child and a child’s self image, especially as the child moves into adolescence. Children's Hospital has a clinic to treat chest wall deformities, specifically pectus carinatum (pigeon chest) and pectus excavatum (funnel chest). Heath problems from chest wall deformities can include difficulty breathing, problems tolerating exercise and other physical limitations, chest pain, frequent respiratory infections and heart palpitations.
Under the direction of the Pediatric Surgery Group at Children’s Hospital, the clinic is a multidisciplinary clinic where a patient’s health care team will come together to formulate the best plan for the patient. This includes the surgeons, nurse practitioners, psychologists, subspecialists such as pulmonologists and orthopedists as needed, pain and palliative care clinicians, social workers, care coordinators and other clinicians involved in the patient’s care.
Pectus carinatum (pigeon chest)
Pectus carinatum (pigeon chest) is a disorder of the chest wall because of an unusual growth of the rib and breastbone and gives the chest a birdlike appearance. This condition is treated with an innovative bracing system developed in South America by Argentinean physicians Marcelo Matinez-Ferro, M.D. and Carlos Fraire, M.D. Children’s Hospital is the first hospital in Tennessee and the second in the southeast to use this technology. Each patient receives a custom fitted brace that measures and adjusts pressure on the thoracic wall to gradually push the breastbone back into normal position. Data shows that this therapy leads to fewer difficulties in use, fewer surgeries and better compliance in use by patients. This technology helps to avoid surgery in almost 90 percent of the cases. Duration of treatment varies by severity. The monthly clinic tracks a patient’s progress and the average treatment.
Pectus excavatum (funnel chest or sunken chest)
Pectus excavatum (funnel chest or sunken chest) is a congenital deformity of the chest wall that causes several ribs and the breastbone/sternum to grow in an inward direction. Early referral to a pediatric surgeon for patients with mild or moderate deformities is important to determine surgical options and optimize treatment. For younger patients that are not candidates, or do not desire surgery, a vacuum bell may be used on the chest creating a vacuum seal that can gradually lift the sternum over time. The vacuum bell can also be used in severe cases to achieve partial correction that will make the operative correction technically easier.
The current state-of-the-art operative procedure for correction of pectus excavatum is the minimally invasive placement of a stainless steel bar to reconfigure the chest wall, known as the Nuss procedure. Our entire team has extensive experience with this operative technique.
Last year, the pediatric surgeons at East Tennessee Children's Hospital treated 69 patients for pectus excavatum and pectus carnatum. The chest wall clinic started accepting patients in February 2019.
For more information about this clinic, call Children's Hospital Pediatric Surgery Group at (865) 546-2131.