Pectus Excavatum

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Pectus Excavatum (PE), also known as funnel chest, is a condition in which a person’s breastbone is sunken into his or her chest leaving a dent in the front of the chest. It happens because these ribs and the breastbone grow abnormally in an inward direction. It is more common in boys than in girls and typically worsens during the adolescent growth spurt. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. Even mild cases of pectus excavatum can make a person feel self-conscious about their appearance. There are different treatments for PE depending on the severity of the deformity. Most cases of PE also have a Rib Flare component. In mild cases wof PE that have a Rib fflare, bracing to reduce the Rib Flare has the additional benefit of reducing the excavatum.

Treatment Options

There are four possible treatment options for Pectus Excavatum:

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Mild PE

Exercises to attempt to reduce the appearance of Rib Flare fall into 2 categories.

1. Exercises designed to try to reposition the rib cage slightly to thereby realign the ribs. These include breathing exercises to strengthen the diaphragm and abdominal exercises to strengthen the core.

2. Chest exercise to build up the chest muscles to mask the deformity.

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Mild PE + Rib Flare

Patients who have a mild PE and prominent rib flare deformity can be effectively treated with the LA Rib Flaring Brace Treatment Program.  Studies have shown that correction of Rib Fare has the additional benefit of having a slight lifting effect on PE, thereby improving both the Rib Flare and the Pectus Excavatum. The LA Bracing technique is different to other bracing options. Through the fitting of multiple patients, we have determined that rib flare responds best to antero-posterior force application principles of treatment. We apply our same Pectus Bracing algorithms to rib flare deformity to determine the correct force application and time needed for optimum correction and offer those with PE + Rib Flare, the ‘LA Rib Flare Treatment Program’ to maximize the results of brace treatment. For each patient we design a program to successfully achieve the best outcome in the shortest possible time.

To order the LA Rib Flaring Brace,   Click Here

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Moderate PE

The vacuum bell is a conservative method for correcting pectus excavatum through non-invasive treatment over a period of time. It is a rubber bell (or cup) shaped device that connects to a pump and is placed directly on the chest. It creates a vacuum seal on the chest wall which applies an outwards force to the breastbone thereby lifting the sternum forwards. Over time, the chest wall and breastbone stay forward on their own and hold a new shape. The device can be used during school/work, sports and other daily activities. For those wishing to purchase the Vacuum Bell, we currently recommend PectusHealing.com 

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Severe PE

Severe cases of PE are treated with surgery.  The two most common surgical procedures for pectus excavatum are:

Nuss procedure. This minimally invasive procedure uses small incisions placed on each side of the chest. Long-handled tools and a narrow fiber-optic camera are inserted through the incisions. A curved metal bar is threaded under the depressed breastbone, to raise it into a more normal position. The bars are typically removed after two or three years.

Ravitch technique. This older procedure requires a much larger incision down the center of the chest. The surgeon removes the deformed cartilage attaching the ribs to the lower breastbone and then fixes the breastbone into a more normal position with surgical hardware, such as a metal strut or mesh supports. These supports are usually removed in six to 12 months.