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At least 73 records · Page 4Linked to original sources
PubMed2000

[Mini mid-line skin incision--a more cosmetic challenge for surgery of funnel chest: report of a case].

We performed a operation using a mini mid-line skin incision for ten-year-old male with funnel chest. The skin incision was made from the level of nipple to the lower end of the xiphoid process. He had sternal elevation as corrective surgery. There was no complication and he discharged at 11th day after surgery. We believe our method is more appropriate in fulfilling the cosmetic needs for the patient of funnel chest.

Child↗
PubMed2006

[The reconstruction of funnel chest deformity with the reversed transplantation of sternum-costicartilage flap carried by the abdominal rectus pedicle].

OBJECTIVE: To investigate the reconstructive operative procedures of funnel chest with "sternum-costicartilage" flap carried by the abdominal rectus pedicle. METHODS: (1) In accordance with the lesioned area of funnel-like depressed deformity of anterior thoracic wall, a perpendicular median incision was designed and made; (2) The "sternum-costicartilage" flap carrying the abdominal rectus pedicle was used and reversed and transplanted to reconstruct severe funnel chest deformity. RESULTS: The procedure was used in 7 cases from 1999 to 2005. The results of surgery were satisfactory. There were no recurrence after operation. CONCLUSIONS: The procedure reported here is rather safe, solid and sound with good therapeutic results, and is of great value in clinical practice.

Bone Transplantation↗
PubMed1986

A new, modified operation for funnel chest using the Zimmer osteosynthetic plate.

A corrective operation for funnel chest using a Zimmer osteosynthetic plate, which can be bent to any configuration desired, is described. This operative method can be employed for any type of chest deformity in adults and adolescents. A physiologically normal and perfectly stabilized anterior chest wall is obtained with this plate system, and no relapse occurs even after removal of the plate.

Adolescent↗
PubMed1975

[Funnel-chest and cardio-pericardial pathology, apropos of 2 cases treated by pericardioplasty and parietal remodelling].

Numerous pathogenic hypotheses were put forward to explain the Funnel Chest. It is possible that the origin of this malformation is not related to an involvement of the thoracic wall or the diaphragm, but rather to a negative pressure behind the sternum which is attracted by inspiratory movements, this resulting in, and aggravating the malformation. This negative pressure of the anterior mediastinum would result from an absent cardiac mass which was displaced leftward, favoured by an enlarged and flaccid pericardial sac. Haemodynamic examination of the subjects with a funnel chest has a two-fold interest: it provides the data for a physiopathologic study. Particularly the measurement of the right ventricular pressure which becomes negative on deep inspiration. On the other hand, it makes it possible to demonstrate the presence or the absence of any cardiac lesion combined with the deformity. The angiographic pictures demonstrate the distortion of the right ventricular chamber in particular, and the elongation of the inferior vena cava. Among the various classical treatments, some aim at cosmetic improvement, others at thoracic wall correction. However, the latter do not prevent recurrence in the child, and are too severe a procedure in the adult. This is why a new treatment is put forward, on the basis of the new pathogenic considerations: repositioning of the cardiac mass displaced leftward, after a pericardoplasty, combined with remodelling of the excavated thoracic wall. Thus cardiac reposition into the anterior mediastinum avoids a long-term recurrence of the deformity. In our experience, pericardioplasty combined with thoracic wall remodelling has given good results, both immediate and delayed, in the two cases in which it was performed. A longer series, particularly on the younger child, is necessary to form an opinion on the value of this procedure.

Adult↗
PubMed1993

[Early and long-term results of sternocostal elevation combined with bridge external traction for funnel chest in children].

The purpose of the present study is to evaluate the effects of addition of a bridge external traction to our conventional sternocostal elevation technique in the surgical management of funnel chest in children. During the period from 1970 to 1979, a total of 29 children with funnel chest were treated surgically using sternocostal elevation technique (Group I). Operative technique consisted of total subperichondral resection of deformed costal cartilages (usually 3rd to 8th, bilaterally), transection of deformed portion of the sternum in 2-3 points and fixation of the sternum in elevated position using 2 Kirschner wires, and shortening resuturing of the opened perichondrium. Since 1980, an addition of the bridge external traction to our conventional sternocostal elevation technique was applied for about 10 days after operation in 82 consecutive children (Group II). The vertebral index (B/A = sagittal diameter of vertebral body/minimum sternovertebral distance), D/C ratio (maximum sagittal depth of depression of sternum/distance from anterior surface of the vertebral body to the sternum at Louis's angle) and E/C ratio (E = minimal sagittal distance from anterior surface of the vertebral body to the sternum) were measured in all cases and compared before and after operation and also between the two Groups. Preoperatively, there was no significant difference in all 3 indices between the two Groups. Postoperative B/A, D/C and E/C ratio in Group I were 0.28 +/- 0.06, 0.14 +/- 0.19, 1.09 +/- 0.32 (mean +/- SD), respectively. There were a significant drop in D/C ratio and a significant elevation in E/C ratio after operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Abnormal structure of type II collagen in a patients with funnel chest].

The electrophoretical analysis and CNBr-peptide mapping of the collagens, isolated from the costal cartilage of 30 patients with non-classified and syndromal forms of pex excavatum (funnel chest) (27 patients) and pex carinatum (3 patients) was carried out. In case of one patient with the nonclassified form of funnel chest the electrophoretical mobility of CB 9.7-peptide was found to be decreased. The electrophoretical mobilities of other peptides are not markedly changed. The data obtained allow one to suggest the mutation causing the defect in the region about 160 amino acid residues distant from the C-end of alpha 1 (II) chain of type II collagen of the patient.

Adolescent↗
PubMed2000

Surgical correction of funnel chest.

AIM: To present our experience in surgical treatment of funnel chest. MATERIAL AND METHODS: Seven patients (6 males and 1 female) aged 13 to 18 years were treated in the Department using Rathke-Schlegel's modification of Ravitch operative technique. In 2 patients the corrected deformity status was maintained by 2 Kirschner's pins that were placed substernally and attached bilaterally to the adjacent ribs. In one patient a direct traction through the sternum was applied and in 4 patients the fixation was achieved by fastening the sternum with wire loops to an overlying AO plate. RESULTS: Very good results were achieved in 4 patients (57.14%) and a good outcome was evaluated in 3 patients with 30% recurrence of the deformity. There was no lethal outcome. Three complications were encountered: in one patient hemothorax occurred that was cured by a single punction aspiration, in other patient one of the Kirschner's pins slipped into the thoracic cavity. The pin but did not injure intrathoracic organs and was promptly removed. In the third patient earlier removal of the plate was required because suppuration developed. CONCLUSION: The presented method for correction of chest deformity is successful if the implants are kept in place from 6 to 12 months. This time is sufficient for formation of a solid callus that prevents recurrence of the deformity.

Adolescent↗
PubMed1993

[One-staged operation for funnel chest, mitral regurgitation and annulo-aortic ectasia associated of Marfan's syndrome].

One-staged operation was successfully performed in a 23-year-old female with funnel chest, mitral regurgitation and annulo aortic ectasia secondary to Marfan's syndrome. A midline skin incision was made and the sternum and costal cartilages were mobilized for sternal turnover with rectus muscles pedicle. This procedure offered an excellent operative field, even though the heart and aneurysmal ascending aorta were displaced into the left hemithorax. The combined superior-transseptal approach to the left atrium was used to perform mitral valve replacement. This approach also provided an excellent exposure of the mitral valve. Cabrol's operation was done for annulo aortic ectasia. Our concepts for the operation of open heart surgery complicated with severe funnel chest were discussed.

Adult↗
PubMedDate not supplied

[Late results following surgery for funnel chest].

36 out of 62 patients, who underwent surgical correction for funnel chest deformity between 1978 and 1988 with an average follow-up of 7.6 years have been reviewed. The mean age, Hegemann operation was performed, was 14.1 years. 76% of patients reported preoperatively cardiorespiratory disorders, 71% showed electrocardiographic and pulmonary alterations. Postoperatively significant reduction of cardiorespiratory disorders but no significant reduction of electrocardiographic changes were seen. The pre- and postoperative radiological and functional measurements of the chest deformity which provides an objective evaluation of the surgical result are described. Surgical treatment is indicated in most of cases for cosmetic or psychic reasons. The long-term results were good or fair in 90% or more of our cases. We suggested that disfiguring scars with keloid formation causes less mental stress than persistent congenital malformation of the chest.

Adolescent↗
PubMedDate not supplied

[Extractability of collagen from the rib cartilage and skin in funnel chest in children].

Content of collagen and relative content of unextractable collagen were increased by 35% and 50%, respectively, while the content of immobilized water was decreased in costal cartilage of children with the isolated form of funnel chest or with the deformation accompanied by Ehlers-Danlos syndrome. These anomalies may be considered as indicators of the cartilage premature ageing. In skin of the children with isolated form of funnel chest the ratio of collagen extracted with acetic acid was increased 2-fold.

Cartilage↗
PubMed1977

[Funnel chest operation and age (author's transl)].

Analysing 199 cases of funnel chest operations the following proposals are to be discussed: early operation of boys in a modified Ravitch-technique with transverse osteotomy of the anterior sternum-wall, resection of the xiphoid process and fastening of the perichondrium to the pectoral muscles. The cosmetic indication excludes a late operation. If any late operations are performed they should be considered only for girls. Stabilisers should be used only in case of later operations, recurrences and asymmetrical forms. No operation should be performed in case of genetic defects (malformationsyndrome, flat-chest and channel-chest). The therapeutic results should be made objective by means of the sagittal inner thorax-diameter after Stucki. The submammary incision should be omitted.

Adolescent↗
PubMed1989

[Light microscopic studies of the cartilage in funnel chest. A new view of the pathogenesis].

In patients with a funnel chest, light-microscopic studies of their rib cartilage showed vessels in all slices of the cartilage. In all analysed stages of life there is a constant number of vessels per unit area; even in not deformed parts of the cartilage. Furthermore, the number of the chondrocytes strongly increases within the single chondrons with rising age in an extraordinary way.

Adolescent↗
PubMed1991

[Differentiated approach to the method of sternum stabilization in surgical treatment of funnel chest in children].

Experience in surgical treatment of 186 patients with funnel chest deformity (FCD) is generalized. With consideration for the great variety of the forms of deformity of the plastron, simple and complicated forms of FCD are distinguished. The simple forms include isolated, symmetrical, low (beginning from the level of the fourth rib) II-III degree deformities, the complicated forms include wide, II-III degree deformities beginning from the level of the second rib, and flat asymmetrical deformities. The use of a metal plate as a stabilizer in complicated forms of FCD is suggested. The optimal method of treatment in simple forms of the deformity is thoracoplasty with fixation of the sternum in the corrected position by means of a nitinol clip.

Adolescent↗
PubMed2005

Late-onset hemothorax after the Nuss procedure for funnel chest.

A 4-year-and-3-month-old boy with funnel chest underwent the Nuss procedure. He had an uneventful intraoperative and postoperative course, and was discharged on the tenth day of hospitalization. He developed chest pain while playing on the 29th day after surgery, and was diagnosed with right hemothorax. He was followed conservatively and the hemothorax disappeared.

Child, Preschool↗
PubMed1985

A new surgical method for repair of funnel chest.

We have devised a new surgical procedure for the repair of funnel chest deformity, which we have used in 148 of our 154 patients. The procedure involves resection of the deformed thoracic wall, including ribs and sternum, rib-sternal turnover, and anastomosis of the internal thoracic artery and veins. Several preoperative and postoperative examinations, such as bone biopsy, sternal puncture and indium chloride test, revealed definite signs of living tissue. This procedure results in minimal secondary deformity postoperatively and is indicated for adults as well as children.

Adult↗