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Pectus Excavatum (Funnel Chest)

Pectus Excavatum (Funnel Chest)
 
Pectus excavatum is an anterior chest wall deformity in which sternum and cartilage ribs are depressed into the thoracic cage in various degrees.It is also the most frequent abnormality of the chest wall.The deformity might be obvious since birth or  might be obvious after infancy  and has a tendency to detoriarate.It is stabilized usually in the age of 7-9.In most of the cases the depression  in the corpus of the sternum and the depth is maximum in the xiphoid level.The xiphoid process might be rudimantated,might be below the sternum,it might be clefted,rotated or deviated in one side.
 
It is a rare occasion of the integration of the first two ribs with the depression.The deformity might be centralized or asymetric;in the cases with asymetric deformity the depression is mostly in the right side and sternum's right rotation in the vertical axis is integrated with the occasion.In the girls with this type of deformity the right breast is smaller than the left.In the cases with severe pectus excavatum deformity the depression is very deep and the sternum might even touch the vertebra.The children with pectus excavatum deformity has a thin and flat chest as well as a slight humpback.In one quarter of the cases scoliosis accompanies.
 
In normal population pectus excavatum is observed in 1 of every 300 births .It's seen more in males;the ratio is 3:1.The symptoms varies due to the severity of the deformity.In more severe deformities angina by effort,palpitation and restriction in the effort capacity is expected.In cases with Mitral Valve Prolapsus(MVP),MVP is the possible reason for these symptoms and is associated in %15 of the cases
 
In pectus excavatum due to the absence of severe cardiovascular and pulmoner disorder the problem might be perceived as cosmetic.On the other hand in children with intermediate and severe deformity ,the operation enhances the physical capacity of the children.