Source: Indys Child Parenting Magazine

Understanding Chest Wall Deformities
Knowing how to treat them and when to see a specialist

by Dr. Frederick Rescorla

January 01, 2012

If your childís chest area appears to be caved in or bulging, it may be a sign of a chest wall deformity. While some deformities are cosmetic and pose no health concerns, more severe ones are linked to breathing problems, chest pains and heart issues. Severe cases are often noticed at birth, but the deformity may worsen as the child develops, especially through puberty. Here is what you need to know about these deformities and how they can be treated.

What are chest wall deformities?

Chest wall deformities are structural issues with the ribs and cartilage. While they are not preventable, they are treatable.

There are two types of chest wall deformities. One is called pectus excavatum or funnel chest. This is where the breastbone (sternum) is pushed inward. Sometimes the two sides of the chest can appear uneven. This type of deformity can be mild to very severe. Many children and adults with pectus excavatum donít have symptoms, but may be self-conscious of their appearance. Some children may experience symptoms. These can include breathing problems, because there is less room for their lungs to expand, or chest pains, because their heart might be compressed or displaced.

Pectus carinatum or pigeon breast is a deformity where the chest sticks out, similar to a birdís chest. It is much less common than other chest defects. Similar to pectus excavatum, many children do not have symptoms, but are self-conscious about their appearance. Some may experience chest pains, breathing or heart problems.

How can these deformities be treated?

For both types of chest wall deformities, minor cases are monitored and no medical treatment is needed. However, some families may ultimately opt for cosmetic procedures to correct the deformity.

With pectus excavatum, physical therapy sometimes can slow development or potentially reverse the deformity in children. Surgery may be needed to improve a childís breathing, posture and heart function.

For pectus carinatum, treatment options include non-surgical bracing and surgery. Because the chest wall remains relatively flexible in young people until they reach early adulthood, wearing a brace over the chest wall can help re-mold it into a normal shape. Surgery may also be an option.

When should my child see a specialist?

Visiting a specialist while your child is very young may help you understand whether your child has a mild, moderate or severe deformity. Unless your child has a severe deformity, physical therapy or bracing would wait until he or she is more than six-years-old. Surgery is more likely during the teen years after most growth spurts have ended.

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