New Technique Corrects Pigeon Chest in Children
Surgery to correct pigeon chest in children can be especially invasive and traumatic when the deformity is severe. Now surgeons from South America have developed a minimally invasive surgical technique to correct this condition.
Pigeon breast (pectus carinatum) is a chest wall deformity in which the breastbone is pushed outward. Approximately one in 900 children has the condition, which develops in girls at a younger age than boys, who usually present with the condition at about age 11 to 14. The deformity often grows more severe until the child reaches full growth. Pigeon chest is often accompanied by scoliosis.
The cause of pigeon chest is not known, although genetics appears to play a role. Symptoms include difficulties exercising and playing, and tenderness and intermittent pain in the area of overgrown cartilage. Pigeon chest typically worsens until late adolescence, and surgery may be necessary. Until now, surgery has included removing the involved rib cartilage and repositioning the breastbone to restore normal chest curvature. Because this approach is highly traumatic and invasive, many affected children do not undergo the procedure.
The new surgical approach is a variation of the Nuss technique, named after pediatric surgeon Dr. Donald Nuss of Children’s Hospital of The Kings Daughters (CHKD), who developed a minimally invasive technique to correct a related chest deformity called funnel chest. This condition is the opposite of pigeon chest in that the chest in sunken rather than protruding.
Surgeons in South America developed the new surgical technique, which some physicians call a reverse Nuss. It involves placing a bar into the chest cavity above the ribs, which pushes down the protruding cartilage. When the pigeon chest is resolved, the bar is removed.
The new surgical technique for pigeon chest was demonstrated by Dr. Robert Kelly, a pediatric surgeon at CHKD, at the recent 8th International Nuss Conference. During the same conference, several CHKD surgeons, physicians, and physical therapists also demonstrated a new dynamic compression brace, which can correct pigeon chest using an approach that is similar to how braces straighten crooked teeth.
Both the new surgical technique and the dynamic compression brace represent “major advances in correction of pectus carinatum,” noted Dr. Nuss. Pigeon chest is a source of significant physical and emotional pain for children. Part of CHKD’s goal is to advance and promote the latest and most effective techniques for correcting chest wall deformities to surgeons around the world so fewer children have to live with the deformity.
Children’s Hospital of The Kings Daughters
Children’s Hospital Boston