;Resize=(1200,627)&impolicy=perceptual&quality=mediumHigh&hash=2e5011be1d53de764691047f7f7c258430a95db667d0310e918349ec2acc72c4 "Pectus excavatum: More and more boys and men are being treated")
“Very large increase”: More and more boys and men are having pectus excavatum treated
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There is no genetic engineering in the plant
But don’t worry: they’re genetically modified
In a so-called funnel chest, the breast bulges inwards. It doesn’t have to be, but it can cause pain. It also bothers some people who are affected. A senior physician about the medical background and treatment options.
One in 400 boys and one in 1600 girls have what is known as a pectus excavatum. The chest arches inwards. “The breastbone and usually some of the ribs grow abnormally and cause a constriction in the middle of the chest,” explains Stefan Klohs, senior physician in the clinic and polyclinic for pediatric surgery at the University Hospital Hamburg-Eppendorf (UKE).
It is a congenital deformity of the chest wall that often cannot be seen at first. “But it grows with the child,” says Klohs. Any growth spurt can potentially amplify it.
Pectus excavatum – these are the symptoms
Most sufferers have only a mild form of pectus excavatum and no symptoms. Treatment is then not necessary. However, it can also be painful, explains Klohs. “A very pronounced funnel chest can put pressure on the heart and lungs, which is particularly noticeable under stress or during sports.”
The doctor mentions the following symptoms:
hollow depression in the chest, which may be wide and shallow, deep and narrow, or irregular flattening of the side ribs prominent rib cage breathing faster than normal shortness of breath with exertion or exercise chest pain lateral curvature of the spine, marked curvature of the upper back, slouched shoulders
Exact cause unclear, genetic basis “very likely”
The exact cause of a funnel chest has not yet been finally clarified. However, the experts at the university hospital were able to determine a family frequency of 30 percent in their own investigation. “That makes a genetic basis very likely,” says Klohs.
Other theories are also discussed. For example, pressure was already being exerted on the baby’s chest in the womb. According to Klohs, rickets, diaphragmatic defects or weakness of the connective tissue are also potential (co-)causes of a funnel chest.
More and more boys and men are having funnel chest treated
The senior physician observed a “very large increase” – both in terms of consultation appointments and treatments. Because the funnel chest is four times more common in them, the expert observes this increase in boys and men in particular.
The expert sees two reasons for the increasing number of treatments:
Information situation: More and more people know what a funnel chest is and that it can also cause symptoms such as shortness of breath or chest pain. “Those affected come to our consultation hours and have always been told: ‘There’s nothing you can do about it.’ But the information and treatment options have greatly improved.”
Aesthetics: In times of social media, a stronger focus on one’s own appearance can be observed in many areas (see, for example, the increase in cosmetic surgery at a young age). “Some of those affected also want to have their funnel chest treated for optical reasons,” says Klohs.
Funnel chest – these 3 treatment options are available
The UKE team usually carries out several examinations. Cardiac ultrasound, lung function tests and often also magnetic resonance imaging (MRI) of the chest are ordered. In the case of a majority, no further treatment is then necessary, according to the doctor.
However, if treatment is necessary or desired, this can be done using the following methods:
Straightening of the funnel chest with metal brackets (surgery according to Nuss/MIRPE):
minimally invasive procedure in which one or two metal brackets are pushed into the chest and straighten it OP lasts around an hour, then the patient has to come to the clinic for follow-up for around a week Treatment is ideally from 15 to 17 years or when Patients are almost fully grown, but it is still possible over the age of 18
Straightening of the funnel chest with a suction cup (no surgery):
only recommended for mild forms of funnel chest, two hours of self-application daily for several years, ideally at age 13 to 14, but possible up to age 18
Compensation of the funnel by inserting a silicone prosthesis (OP):
purely cosmetic procedure silicone cushion is pushed under the skin theoretically possible for life, but surgery only after 18 years if the patient decides for himself
According to Klohs, a preliminary discussion always clarifies whether an operation is really necessary. For him, it is crucial whether the finding is pronounced (severe form) and whether there are understandable medical problems. Some of those affected also suffer psychologically from their funnel chest, which is also taken into account.
Die Cost the health insurance companies take care of the diagnostics. The treatment costs are usually only covered in the case of physical impairments.
Low risk of treatments
The suction cup treatment is non-surgical and therefore poses no risks if used correctly. The insertion of the silicone prosthesis is also low-risk, according to the pediatric surgeon.
“In the operation according to Nuss, you have to go straight through the chest, so that’s a major operation,” explains Klohs. “However, it is now so common, so frequent and camera-assisted (also pushed into the chest) that it can also be described as low-risk.”
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