Treatment of Pectus Excavatum / Pectus Carinatum
Pectus excavatum is a congenital alteration of the chest wall, characterized by a funnel-shaped indentation of the chest. We closely examine both pectus excavatum and pectus carinatum, highlighting the treatment options and causes of each.
What is Pectus Excavatum?
Pectus excavatum, also known as funnel chest, is named after the funnel-shaped indentation of the anterior chest wall. This indentation is due to changes in the cartilaginous connections between the sternum and ribs. Pectus excavatum can appear symmetrically or asymmetrically depending on the individual.
It is important to note that a congenital pectus excavatum can be exacerbated during growth. Psychological effects are particularly noteworthy, although respiratory problems are less common.
Pectus excavatum, also known as funnel chest, is named after the funnel-shaped indentation of the anterior chest wall. This indentation is due to changes in the cartilaginous connections between the sternum and ribs. Pectus excavatum can appear symmetrically or asymmetrically depending on the individual.
It is important to note that a congenital pectus excavatum can be exacerbated during growth. Psychological effects are particularly noteworthy, although respiratory problems are less common.
Causes of Pectus Excavatum
The exact causes of pectus excavatum are still unclear. However, it is often observed that the condition occurs more frequently within families. It is very common for pectus excavatum to be associated with or exacerbated by other spinal deformities. Other conditions like Marfan Syndrome may also be related.
The Difference Between Pectus Carinatum and Pectus Excavatum
In pectus carinatum, known as pigeon chest, the sternum protrudes due to defective development of the rib connections. The rib connections develop improperly, which is particularly noticeable during puberty.
The deformation of the chest wall thus varies between pectus carinatum and pectus excavatum. Pectus carinatum is much less common than pectus excavatum and is mainly observed in boys during puberty.
Consequences of Pectus Carinatum and Pectus Excavatum
Initially, it is important to note that neither pectus carinatum nor pectus excavatum generally causes impairment of respiratory or circulatory function. However, poor posture is widespread as individuals attempt to conceal the deformity. In severe cases, the intense pressure of the sternum can cause pain.
However, the psychological burden is high, as the visual impairment is perceived as very significant. Many individuals feel ashamed of the condition, which is exacerbated during puberty and thus becomes more visible.
Care for Pectus Carinatum at ergonomic care
Pectus Carinatum Orthosis with Tension Joint
Pectus Carinatum Orthosis with Ski Closure
Conclusion on the Care of Pectus Carinatum and Pectus Excavatum
As long as the pectus carinatum brace or the vacuum bell is consistently worn, the treatment success is very high. The aforementioned deformities can be treated during growth without the need for surgical interventions. In most cases, the visual limitations completely disappear if therapy is started early.
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Frequently Asked Questions
What treatment methods are available for Pectus Carinatum and Pectus Excavatum?
A variety of treatment methods are available for both pectus carinatum and pectus excavatum. While there are surgical treatment methods, the focus is always on non-surgical treatment methods, which include, for example, appropriate physiotherapy. A specially fitted corset supports patients during growth. Additional options include a pectus carinatum orthosis and the use of a vacuum bell for pectus excavatum, which will be discussed in more detail below
How is Pectus Excavatum treated with a vacuum bell?
This involves the lifting and subsequent fixation of the pectus excavatum in a non-invasive manner. The chest wall is raised by creating a vacuum with a vacuum bell. In many cases, this already has a positive effect. It is crucial thereafter to maintain the elevated position of the chest wall.
It should be noted that the internal muscles, such as the diaphragm, tend to revert to the sunken form. However, the resistance of the cartilage, ligaments, and bones is relatively easily overcome by the vacuum bell. The involved muscles, however, need to be stretched by the vacuum bell to stay in the new position. This means that a vacuum bell must be used for a certain period as part of the therapy.
Interestingly, a vacuum bell can be worn without problems over longer periods. It can be worn while walking, lying down, or attending school, which results in the pectus excavatum being gradually lifted and maintained in a healthy position.
How is Pectus Carinatum treated with an orthosis?
The pectus carinatum orthosis is a common treatment method for pectus carinatum. The pectus carinatum orthosis, also known as a pectus carinatum brace, applies pressure to correct the deformity. It is important that the individuals are still growing, as the pectus carinatum orthosis utilizes growth to correct the deformity through compression therapy.
The pressure applied by the pectus carinatum orthosis can be adjusted to achieve the best results. It is important for a pectus carinatum brace to be light and easy to wear. Since it is a visually inconspicuous aid, it can be worn under clothing without any problems. As long as the pectus carinatum orthosis is worn regularly, the deformity can be corrected over time. The results from this treatment method are very convincing if the pectus carinatum brace is truly worn consistently. Normally, this means wearing it for about 23 hours a day over a period of several months. The exact wearing time and adjustments are made individually.
Exemplary image of a pectus carinatum orthosis from our medical supply store:
