At Montana Children's Specialists we offer unique expertise in an exceptional setting for chest wall deformity treatment in Montana. We follow standardized treatment protocols and collaborate with high volume centers to assure consistent quality and outcomes. We are located 20 minutes from Glacier Park International Airport and can provide assistance with transportation and housing. Our team of specialized and fellowship trained providers closely collaborates with subspecialized pediatric physicians and nurses to assure highest quality treatment in an age appropriate environment.
About Chest Wall Deformities
Chest wall deformities are common birth defects occurring in about 1 of 300-500 children in the United States. Most of them are benign (noncancerous) variants of a normal chest shape and have no impact on lung or heart function. There are two forms of chest wall deformities: Pectus Excavatum (“Funnel Chest”) and Pectus Carinatum (“Pigeon Chest”).
What is Pectus Excavatum (“Funnel Chest”)?
Pectus Excavatum, also called funnel chest, is the most common chest wall deformity. It is three times more common in boys than girls. The chest appears sunken or caved in, caused by an inward growth of the breastbone and portions of the ribs. The cause for this deformity is not completely understood. Like Pectus Carinatum, this condition can be present at birth but becomes more pronounced during the pubertal growth spurt. Possible symptoms include chest pain, exercise intolerance or shortness of breath. Many teenagers with a sunken chest suffer from psychological symptoms that manifest with feelings of embarrassment and social anxiety.
How is Pectus Excavatum treated?
After a thorough exam, we may recommend tests to examine the anatomy and function of the lungs and heart. In asymptomatic patients with normal heart and lung function, the repair is optional. The repair of Pectus Excavatum can be achieved with a minimally invasive approach or an operation involving an incision on the chest. In many cases, the minimally invasive techniques can be applied. This involves temporary placement of a metal bar in to chest (Nuss bar), which immediately corrects the sunken chest. The bar needs to be removed in another surgery after approximately three years.
An alternative to this technique is an open corrective chest wall repair with a larger incision in the middle of the chest. This procedures involves resection of abnormal ribs and repositioning of the sternum.
Both surgical techniques require a 5-7 day hospital stay.
What is Pectus Carinatum (“Pigeon Chest”)?
Pectus Carinatum, also called pigeon chest, is a deformity of the breastbone and rib cartilages that causes the chest to stick out. It is less common than Pectus Excavatum. This condition can be present at birth. In most cases it becomes more evident and more pronounced in the early teenage years. The cause for Pectus Carinatum is not known. Some children with this protruding chest have pain, shortness of breath or exercise intolerance. In many cases it does not cause any symptoms. Pectus Carinatum can have a negative psychological impact.
How is Pectus Carinatum treated?
In patients without symptoms, treatment is optional. We may recommend tests to examine the anatomy and function of the lungs and heart. Pectus carinatum can be treated surgically or nonsurgically. Surgical correction involves a procedure under general anesthesia. It requires an incision in the mid-chest to remove abnormal ribs and reshape the sternum. A hospital stay of approximately one week is necessary. Bracing is a good alternative to surgery for many patients. It requires a long-term commitment as most patients have to wear a metal brace for one to two years. The brace consists of a metal belt and cushioned compression zone. It should be worn as much as possible to apply constant pressure on the protruding chest wall to remold it. The brace can be removed for bathing, showering and sports.
Call our office for more information and an appointment at one of our four locations (Kalispell, Bozeman, Helena, or Great Falls): (406) 758-7089