It’s a common problem. But many kids and their parents don’t talk about it. In fact, chest wall defects are common congenital abnormalities occurring in up to one in 300 live births. The condition is about four times more likely to occur in boys than in girls. Until now, an invasive, often painful surgery was the only option for children and teenagers facing this problem.
Overland Park Regional Medical Center offers surgical and non-surgical interventions for chest wall deformities including pectus excavatum or sunken chest.
What is Sunken Chest?
Like a lot of conditions, pectus excavatum can range from mild to severe. It’s a condition present from birth but it usually doesn’t cause problems until bone growth spurts during adolescence, at which the chest usually sinks more.
The chest area, holding the heart, lungs and other body tissue, is surrounded by the ribcage – attaching to the spine in the back and the sternum (breastbone) in the front. The breastbone is usually positioned so there is a slight dip in the middle of the chest. But if that dip is abnormally deep, it can affect how well the heart and lungs function.
Nuss Procedure is the most common performed surgical treatment for pectus excavatum. This is a minimally invasive surgical procedure through small incisions made on each side of the chest to allow the surgeon to insert a metal support bar underneath the sternum to reverse the depression in the chest. Minimally invasive surgical techniques result in reduced blood loss and shorter operating times that lead to a smoother, faster recovery. The bar is typically left in place for 2-3 years.
Until recently, the Nuss procedure was rarely performed on adults. And, if it was, patients needed to travel out of state to three hospitals that perform the Nuss procedure in adults. Director of Pediatric at Fetal Surgery at Overland Park Regional Medical Center, Corey Iqbal, MD performed the first Nuss Procedure on an adult at our hospital in 2017.
Dustin Lurvey’s sternum was so sunken that it pressed against his heart and lungs. He struggled to breathe whenever he exercised and he could see his heartbeat through his skin. As a child, he was treated for asthma because doctors didn’t connect his symptoms to his sunken chest.
After the Nuss procedure, at 38, Dustin’s chest is flat for the first time in his life. Just six months after his surgery, Dustin can take deep breathes and keep up with his young children.
Overland Park Regional Medical Center is the only hospital in the region to offer an alternative to surgery for patients with pectus excavatum. Mild to moderate pectus excavatum may be improved with the vacuum bell, a non-surgical treatment option for patients with pectus excavatum. The vacuum bell is fitted to each patient to sit comfortably on the chest. A bulb attached to the device generates negative pressure to create a vacuum, which raises the sternum over time. The vacuum slowly pulls up the depressed area of cartilage. It may take several months of use to reach the maximum correction. It may require up to two years of regular use to ensure a durable correction. The device allows patients to use it without interfering with school, sports and other daily activities. It is worn several hours each day over 6-12 months.
For optimal results, the Nuss repair is typically offered during early adolescence, but can be performed with excellent results even in adults. Each patient is evaluated on an individual basis to determine a treatment plan that best suits his/her needs.
We generally do not operate on children under six years of age with pectus excavatum. However, we will evaluate children with all chest wall problems at any age and develop a plan for them on an individual basis.
No, your child is not too old to have pectus corrective surgery. We performed our first pectus corrective surgery on an adult in 2017.
No. If you child's symptoms are worsening, then you should begin the steps to have them evaluated and plan for surgery immediately, but correcting the chest is NEVER an emergency. This is a procedure that must be planned. Take your time. Prepare your family and your child for the procedure.
We encourage our patients to maintain active and healthy lifestyles before and after the surgery. Three months post-surgery, patients can return to competitive sports, however contact sports such as football, boxing, and wrestling, are discouraged.
Yes, we treat all disorders of the chest wall and offer operative and non-operative treatments for pectus carinatum (pigeon chest), Poland syndrome mixed-type defects, slipping rib syndrome and more.