Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Funnel Chest”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1977

Surgical correction of pectus excavatum.

It has been observed that some patients who had correction of funnel chest deformity by methods which failed to provide fixed elevation of the involved sternal segment developed progressive sagging in later years in spite of looking good at the operating table. This has led to the adoption of a new technique of double sternal support. This procedure has resulted in 35 of 37 children (94%) being classified as excellent or satisfactory. This double support was initially established in 1959 by overlapping the upper transsected sternum while maintaining elevation of the lower end with a soft tissue sling of perichondrium and intercostal muscle. Beginning in 1961, a rigid bridge of rib or stainless steel bar was substituted at the lower end of the sternum. This has provided better support and the current preference of using the steel bar has been validated in this group of patients. The few disappointments were related to removal of the bar earlier than desired, failure to excise all the protruding sternal cartilage stumps or rib graft tips and inability to cover the lateral sternal edges with pectoral muscles. If possible, the steel bar should not be removed before 12 mo. When these pitfalls were avoided, the results were almost uniformly excellent. The wisdom of excising all depressed cartilaginous segments, as advocated by Ravitch in 1949, has been substantiated. A submammary transverse incision has provided an excellent cosmetic appearance. The morbidity has been low and the mortality zero. In spite of the absence of objective evidence of cardiopulmonary dysfunction, there seems to be an almost uniform improvement in appearance and in patient activity following successful correction of the funnel chest. The latter may be as much a psychological response as a physiologic one. The low morbidity, satisfactory long term results, and general improvement in the patient's body image and outlook on life indicate the need to offer correction of the severe pectus excavatum deformity to low risk children.

Adolescent↗
PubMed1999

Protrusion and mixed deformities.

BACKGROUND: Considerable confusion is encountered in the literature relating classification respectively surgical repair of the anterior chest wall deformities in view of the asymmetric types which are arbitrarily ranged in one of the two main groups (impressions, protrusions). METHODS: Out of 420 operations 89 (21%) were performed for pure protrusion, and 64 (15%) for mixed deformities, with asymmetric impression and protrusion present at the same time. Mixed deformities were limited to the parasternal area in 10 and extended to the entire anterior chest wall in 54 cases. Surgery was undertaken for both protrusion and mixed deformities beyond 10 years of age in 9.8%, while for a typical funnel chest deformity in 31% (p<0.001). Correction has been achieved performing double subperichondral excisions of the distorted cartilages and - if necessary - subperiosteal wedge incision of the bony segments, completed by a T shape wedge sternal incision. In order to preserve the repaired position a stainless steel stabiliser was introduced for one year behind the sternum and the entire mobilised wall area. RESULTS AND CONCLUSIONS: This method was used hitherto in 60 patients with mixed, respectively severe funnel chest deformities without any complication. The "pectus index" calculated according to the equation A/Bx100, in which A is the internal sterno-vertebral distance and B is the transverse diameter of the chest at the level of the diaphragms in cm (normal values: 35%-45%) was followed for 7.6+/-4.5 years in 63 patients. The preoperative 53+/-7.6% decreased to 44.2+/-6.3% (p<0.05).

Humans↗
PubMed1993

[Analysis of hydroxypyridine cross-links of collagen from human rib cartilage].

Ion-paired reversed-phase high performance liquid chromatography (HPLC) has been used for the analysis of the content of mature collagen crosslinks--hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in biopsy specimens of human rib cartilage from healthy donors (n = 14) and patients with inherited diseases of the connective tissue complicated with funnel chest (n = 17). Analysis of normal tissues reveal the presence of LP (alongside with HP) in embryonal rib cartilage. LP has been found in the rib cartilage of 4 out of 6 patients with funnel chest (FC) associated with Ehlers-Danlos syndrome (EDS); with no signs of this pathology detected in individuals with isolated FC. In rib cartilage of 2 patients with recurrent isolated FC LP has been discovered alongside with the presence of type I collagen. A significant increase of LP content in rib cartilage in a child with clinical phenotype of EDS type VI has been discovered.

Adolescent↗
PubMed1984

[M-mode echocardiographic standardization of interventricular septal motion and its clinical significance].

Systolic and diastolic motions of the interventricular septum (IVS), especially of its lower portion at the level of the chordae tendineae, were evaluated by M-mode echocardiography in normal subjects and in patients with various cardiac disorders. The following conclusions were derived from this study. In normal subjects, downward motion of the IVS exhibited three patterns; namely, P1, between the onset of electrical depolarization and the onset of the second heart sound; P2, between the onset of the second heart sound and the E point of the anterior mitral leaflet; and P3, between the E point of the anterior mitral leaflet and the end of the left ventricular rapid filling phase, during each cardiac cycle. The systolic IVS pattern (P1) of atrial septal defect was classified as follows: Normal type: nearly normal posterior motion during ventricular systole, Flat type: flat motion during ventricular systole, Paradoxical (early systolic) type: anterior motion during the first half of ventricular systole, followed by normal posterior motion, Paradoxical (pansystolic) type: anterior motion during ventricular systole. In atrial septal defect, the right ventricular dimension was markedly increased in the flat and paradoxical (pansystolic) types compared with those of the normal and paradoxical (early systolic) types. Marked downward IVS motion (P2) was observed in cor pulmonale with paradoxical pulse, pulmonary hypertension, Ebstein's anomaly, pulmonic insufficiency, atrial septal defect, funnel chest, tricuspid insufficiency and constrictive pericarditis. In cor pulmonale with paradoxical pulse, the deep downward motion (P2) was observed more distinctly during inspiration compared to expiration, and right ventricular inflow velocity pattern was characterized by an apparent increase in peak flow in velocity of the diastolic rapid filling wave during inspiration. Two interesting findings were a deep "y" trough of the jugular pulse tracing and prominent P2 in funnel chest. Therefore, it was likely that exaggerated P2 seemed to be direct evidence of a marked increase in right ventricular rapid filling in the presence of normal or decreased left ventricular rapid filling. The augmented septal dip of P3 was observed in cases with the third heart sound as in normal subjects, and those with mitral insufficiency, and ventricular septal defect, constrictive pericarditis and mitral stenosis. We theorized that exaggerated P3 results from the "sucking action" secondary to increased left ventricular rapid filling velocity in cases with the third heart sound or constrictive pericarditis.(ABSTRACT TRUNCATED AT 400 WORDS)

Diastole↗
PubMed2000

Reconstruction of congenital chest wall deformities using solid silicone onlay prostheses.

Congenital chest wall deformities include five types: pectus excavatum (funnel chest), pectus carinatum (pigeon breast), Poland's syndrome, defects of sternal fusion, and miscellaneous dysplasias and skeletal disorders. Of these five types, two, pectus excavatum and Poland's syndrome, are defects of the skeletal chest wall. These two specific anomalies comprise the vast majority of congenital defects of the chest wall and, as depression deformities, are readily amenable to surgical correction.

Biocompatible Materials↗
PubMed1982

[Surgical correction of chest wall abnormalities].

Cosmetic aspects often are the indication for operation in funnel chest or pigeon breast. Cardial or respiratory symptoms are only noticed in a few patients. The operative procedure according to Brunner is technically a simple method with low risk, which reaches good cosmetic and long-term results (the recurrence rate is 16,6%). Because of the higher recidivation liability after surgery in early childhood, we recommend surgical correction of the chest wall deformities after the age of 12.

Adolescent↗
PubMed1994

Treatment of sternocostal wall malformations of the child. A series of 210 surgical corrections since 1975.

Of 450 children examined for front chest wall malformations, 210 underwent a corrective operation: 190 funnel chests and 20 pigeon chests. A classification of the anatomic forms is presented which contains 6 groups: vertical cup-shaped (the most common), horizontal cup-shaped, vallecular, mixed, complex with sternal torsion or polymalformations. The operation has been programmed in 64% of the cases between 10 and 18 years, but 36% were operated under 6 years because of a severe functional disturbance. On the technical side, Ravitch's procedure is still used on young infants; for the other cases sternochondro-plasty is to be preferred. The fixation of the chest wall is realized with an original, light, solid elastic material taking little space, and easy to remove. This material is presented. The immediate results: 62% very good, 35% good and 3% mediocre, sometimes do present a pejorative evolution, so that after two years of follow-up we notice: 55% remained perfect, 35% very good, 10% moderate of which, 4% to be reoperated. This deterioration touches more particularly the older children operated between 16 and 18 years. Among the children between 3 and 6 years the results are usually very good and remain stable with growth.

Adolescent↗
PubMed1992

Twenty years of experience with particulate silicone in plastic surgery.

The use of particulate silicone in plastic surgery involves the introduction of solid silicone into the body. The silicone is in small pieces in order for it to adapt to the shape of the defect. This way large quantities can be introduced through small incisions. It is also possible to distribute the silicone particles from outside the skin to make the corrections more regular. This method has been very useful for correcting post-traumatic depressions in the face and all areas where the depression has a rigid back support. We consider it the treatment of choice for correcting the funnel chest deformity.

Face↗
PubMed1989

Chest wall deformities.

Chest wall deformities are principally depression deformities, the most common being pectus excavatum (funnel chest). The most common protrusion deformity is pectus carinatum (pigeon breast). Pectus carinatum is a cosmetic problem, but its presence can be psychologically devastating to the patient. Pectus excavatum is definitely a physiologic problem, the effects of which may be reversible by surgical correction. Surgery is safe, complications are minimal, and results are usually satisfactory.

Funnel Chest↗
PubMed1999

A new method of reconstruction for pectus excavatum that preserves blood supply and costal cartilage.

We began in 1982 to use a modified Ravitch procedure that preserves the blood supply to the sternum to correct funnel chest deformities, but there were some problems such as postoperative paradoxical respiration, chest wall irregularity, and palpable heart beat. To resolve these problems, the concept of Jensen's procedure was incorporated into the authors' previous method. In Jensen's method, only a small portion of the deformed cartilages is resected, and almost all of them are preserved. A preformed stainless steel strut is used for chest wall stabilization. The authors preserved the costal cartilages in a manner similar to Jensen's, but the anterior chest wall was stabilized with miniplates and Kirschner wires instead of a large retrosternal strut. The xiphoid process with the lower end of the sternum was detached and moved cephalad. None of the patients developed respiratory failure postoperatively. Although the follow-up periods were short, satisfactory results were obtained with no recurrence of the deformities. The main advantages of our procedure are (1) basic blood supply to the chest wall is preserved, (2) stability of corrected chest wall is maintained with miniplates and Kirschner wires without a large metallic strut, and (3) preserved costal cartilages make the chest wall rigid and the incidence of respiratory failure low. We conclude that this method is simple and produces satisfactory results with a rigid chest wall.

Adolescent↗
PubMed1989

[Clinical and functional manifestations of infundibuliform deformity of the chest].

The clinical picture, respiration function, the condition of the cardiovascular system and metabolism were studied in 102 patients with congenital funnel chest; their ages ranged from 16 to 34 years. The revealed cardio-respiratory and metabolic shifts were caused by the deformity of the chest. After thoracoplasty with a good cosmetic effect the functional disorders are normalized 1-2 years after the operation.

Adolescent↗
PubMed1989

[On the surgical treatment of pectus excavatum].

80 cases of funnel chest were treated surgically, 9 by Gross procedure, 41 by turn-over technique and 30 by reverse "V" shape osteotomy of the sternum and ribs with internal fixation. There were 56 boys and 24 girls, with ages ranging from 2 to 14 years. The sternal depression varied in depth from 3 to 4 cm, and in volume from 20 to 120 ml. Roentgenographically, there were different extents of deviation of the heart to the left. Some patients had abnormal ECG. To study the results of operations, 48 cases were followed-up for 0.5 to 19 years. We found that the results of reverse "V" shape osteotomy of the sternum and ribs with internal fixation were superior to others. Its main advantage lies in the internal fixation which holds the sternum stable thus favoring wound healing and permanent correction. It is simple with less surgical trauma and postoperative complications. Some disappointing results in the other two techniques, such as uneven chest wall, flat chest and forward protruding of the sternum could also be avoided by this procedure. The internal fixation device was removed one year after operation. Follow-up for 3 to 4 years found the chest wall in satisfactory contour.

Adolescent↗
PubMedDate not supplied

Mesenteric neurofibroma with von Recklinghausen's disease: a case report.

Mesenteric neurofibroma associated with von Recklinghausen's disease is rare. Herein, we present one such case. A 15-year-old mentally retarded Japanese boy presented with destruction of the right 2nd and 3rd ribs on a routine chest roentgenogram. Physical examination revealed a funnel chest and multiple cafe-au-lait spots, but no cutaneous nodules. Although the patient had no symptoms, a computed tomography (CT) and angiogram were performed. There were no definitive findings of malignancy in the tumors. However, since there were two risk factors for malignancy, specifically, a young age at the time of diagnosis and multiple tumors, and coupled with the size of the abdominal tumor which was large, the abdominal mesenteric tumor was removed. Pathological examination showed a neurofibroma with no evidence of malignancy.

Adolescent↗
PubMedDate not supplied

[Classification and subclassification of funnel and pigeon chest].

The Willital's clinical classification of funnel- and pigeon-chest deformities can be subclassified by special measurements of the chest. This easy technique enables to differentiate between: Sternocranial, sternocaudal, infrasternal, symmetric and asymmetric marginal and parasternal deformities. This further classification includes deformities of the vertebral column and deviatory development as well. The exact analysis of the abnormal chest in three different planes can be performed by external chest wall measurements that have been developed in our hospital.

Funnel Chest↗
PubMed1981

[Anomalies of the chest (author's transl)].

Presentation of the most important deformities of the thorax, with reference to personal experience and reports from the literature. Next to deformities of the rib-cage, anomalies of the sternum have a prominent place. The principal anomalies of the sternum are the funnel chest and pigeon breast. Neither carries a clear indication for operation. Numerous operative techniques make a comparison of post-op. results difficult. It seems definite that the final results are the same, whether or not the procedure calls for the use of metal prostheses. The degree of success lies between 80-90%.

Child↗
PubMed1989

Oto-palato-digital syndrome in an Iranian infant.

A male infant is presented with wide fontanels, micrognathia, mid-face hypoplasia, hypertelorism, broad nasal root, down-slanting palpebral fissures, small thorax, funnel chest, short wide toes, camptodactyly and cutaneous syndactyly of fingers and toes, dysplastic bones with thin wavy ribs and bowed femore, cryptorchidism, and hypospadias grade I. The mother of this infant showed some signs of the same condition, including hypertelorism, micrognathia, small nose with depressed bridge, flat mid-face, impacted teeth and small chest. This case shows many similarities to oto-palatal-digital syndrome types I and II.

Abnormalities, Multiple↗
PubMedDate not supplied

[Treatment of breastplate deformities: assessment using CT scanning and functional tests].

A study to evaluate both the pre- en postoperative functional and morphologic status of major anterior chest wall deformities. Four of the eight patients suffered from a progressive reduction in physical capabilities. Preoperative pulmonary function tests demonstrated restriction in pulmonary function. In the postoperative period there was progressive return to normal physical strength without objective improvement in pulmonary function. Pre- and postoperative thoracometric study by CT scan allowed us to evaluate the morphologic changes. Two patients with pectus excavatum (funnel chest) demonstrated not only a right-left asymmetry but also A-P compression of the heart without displacement to the left. We consider this to be one of the causes of functional impairment and an absolute indication for corrective surgery.

Adolescent↗