Thoracic deformities usually originate from an overgrowth of the costal cartilages that displaces the sternum inward (pectus excavatum) or outward (pectus carinatum). These alterations progress during childhood, with greater evidence at the onset of puberty. Dr. Franklin Abanto, thoracic and cardiovascular surgeon of our clinic, provides valuable information on this subject.

What are the most common malformations?

The most frequent are pectus excavatum, which represents 80-90% of thoracic deformities, and pectus carinatum. Both are seen more in boys than in girls.

There are other malformations, although less frequent, such as:

• Poland syndrome: Partial or total absence of the pectoralis major muscle, with costal and finger malformations.
• Sprengel syndrome: Congenital elevation of the scapula (one of the two triangular bones at the back of the shoulder).
• Jeune syndrome: bell-shaped thorax and short bones.
• Sternal defects: Fissures or absence of the sternum.

Are there warning signs?

Most of these deformities are asymptomatic, but some children may have decreased exercise tolerance, shortness of breath or chest pain. These symptoms should be evaluated by a specialist.

How are they diagnosed?

Diagnosis includes a review of the medical history, a physical examination by a specialist in thoracic surgery and, in specific cases, cardiological tests, genetic studies, pulmonary function tests and X-rays or CT scans to plan treatment.

What kind of complications can they cause?

In adolescence, these deformities can cause aesthetic and psychological concerns that affect social interaction and self-esteem.

Treatment of thoracic malformations in children depends on the severity:

Conservative: Use of orthopedic devices in mild cases.

Surgical:

• Ravitch technique. Cartilage resection and repositioning of the sternum.
• Nuss technique. Use of metal rods to correct the deformity.

Results:

The surgeries offer satisfactory results, especially in severe deformities, improving both the patient’s appearance and quality of life.

Dr. Franklin Abanto
Thoracic and Cardiovascular surgeon at Clínica Ricardo Palma