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We provide a comprehensive evaluation and treatment of birth defects such as funnel chest (Pectus excavatum) and pigeon chest (Pectus carinatum), using minimally invasive surgical techniques and non-surgical treatments.
Chest deformities affect around one-in-400 people and usually become more severe during adolescence. Some patients complain of chest pain and may undergo many investigations without any cause for their symptoms being found.
Our multidisciplinary team includes specialist thoracic nurses, anaesthetists, occupational and physical therapists. Any chest x-rays or other images required are examined by a dedicated specialist thoracic radiologist.
Our minimally invasive surgical techniques reduce scarring and we have developed very effective ways of minimising pain and using physical therapy to help patients return to normal activities more quickly. You will receive detailed advice on any necessary restrictions after treatment.
Surgical correction: Mr Marco Scarci is experienced in minimally invasive surgery (called the Nuss procedure) for treating both children and adults.
Non-surgical correction: In young patients with a flexible chest and symmetric defect we get good results using a vacuum bell device that literally ‘sucks’ the chest up. The device needs to be worn for several hours every day.
We have the expertise to achieve excellent results correcting even the most complex deformity, using the vacuum bell as part of a combined surgical and non-surgical treatment.
Surgical correction: An incision is made across the chest and the overgrowth of cartilage between the ribs and breastbone is removed. The breastbone is then placed in the usual flat position, with titanium bars sometimes used to stabilize the chest.
Non-surgical correction: Mr Scarci would be very happy to discuss options and suggest the very best and most appropriate treatment for your child. Rather than a ‘one size fits all’ solution, we use the latest model of custom-made pectus brace, which has many important benefits:
There are different types of congenital chest wall deformities. The most commons is the pectus excavatum, also called in simpler terms funnel chest. In this condition the anterior portion of the chest sinks in and forms like a funnel. There are different variant of it according to the severity of the deformity (mild- moderate and severe) and the shape of it. Some can involve just the bottom part of the chest others the entire breast bone, sometime the defect is wide and long and takes the name of grand-canyon variant. This deformity affects nearly 2/3 of all patients and is more prevalent in males. Another common variant is the pectus carinatum or also called pigeon chest. In this condition the breastbone sticks forward like the bow of a ship. It also has different grades of severity and sometime it can also be visible under clothes. This condition affects about the remaining 1/3 of the cases. Lastly there is a rare variant called pectus arcuatum which is a combination of the two previously mentioned defects. Very often this is wrongly diagnosed as pectus excavatum as the chest does sink in, but, more importantly, it also sticks out. It is very important to be familiar with this condition and having diagnosed properly as the wrong diagnosis might lead to the wrong treatment.
Symptoms varies greatly according to the type and severity of the defect. Some patients with a mild conditions have no physical symptoms at all or are very mildly symptomatic. Others with severe defects can experience shortness of breath and pain along the anterior rib cage, especially after exercise. This pain is quite non-specific and it is mostly related to an asymmetry in the rib cage that responds differently to mechanical stress. Shortness of breath is also rather common, but, unfortunately, it is difficult to diagnose it as most patients are young and fit at rest. The problems only become evident during sub-maximal exercise. In this category of patients a cardiopulmonary exercise test might be the best way forward to document the symptoms. Static lung function is not useful in this scenario, nor is a standard chest x-ray.
Consult London's leading thoracic surgeon for expert diagnosis and personalized treatment. Book your appointment today!"
