Have you ever seen a child with a depression in the center of their chest? Pectus excavatum — known commonly as funnel chest — occurs when the breast bone appears sunken into the chest cavity. It’s the most common congenital birth defect and affects one in every 400 babies.
Pectus excavatum occurs in children exclusively; it can develop in the womb or shortly after birth. It occurs when there is overgrowth of the connective tissue between the ribs and the sternum, which results in the breastbone growing inward. Funnel chest happens on its own, and the specific cause remains unknown.
Is it dangerous?
The good news is that only severe cases affect the heart and lungs. More often, the damage is merely emotional for children who might be picked on or otherwise feel self-conscious about their appearance. If your child has pectus excavatum, monitor the condition as they age: growth spurts can make it worse, and it may continue to worsen even into adolescence and adulthood if it is not corrected.
If your child is experiencing pain, feeling lethargic, or having difficulty breathing, it’s important to schedule an appointment with their doctor for a full examination. You should also be on the lookout for signs of emotional distress, such as an aversion to swimming. If a child is experiencing emotional trauma from having the condition, it may be worth discussing treatment options with a doctor.
What should parents do?
If your child isn’t bothered by their appearance and has no breathing problems or other physical ailments, no action needs to be taken. Just continue to monitor for any changes and be supportive. In milder cases, a vacuum bell might be suggested by a doctor to correct the condition. This device, which can be used at home, creates suction on the chest to pull the sternum outward.
If the situation does change, or your doctor recommends treatment, there are two surgical procedures that can treat pectus excavatum.
What surgeries are available?
When necessary, surgical repair of funnel chest ideally occurs during adolescence, as the associated growth in the body at that time helps prevent reoccurrence after surgery. There are two surgeries available: a more traditional open surgery, and a closed, minimally invasive method. A surgeon can help determine which of these two options is best for your child.
Open surgery, or the Ravitch Procedure, involves reshaping the cartilage in the chest; this remedies funnel chest immediately. A surgeon may place metal bars in the chest to help the cartilage keep its shape, but these are removed within 6 to 12 months.
The Nuss Procedure is minimally invasive, which means it uses small incisions to conduct a surgery without opening the chest. While the surgery itself is less involved, it requires placement of metal bars and a plate which remain intact for two to four years while the chest reshapes.
Because funnel chest impacts so many people, educating non-affected children about the condition can be valuable as it will help them be understanding and supportive to their peers.