What Is Pectus Excavatum (Funnel Chest)?
Pectus excavatum is a type of chest wall deformity. It causes your chest to look sunken or indented. This sunken shape is why people sometimes call the condition funnel chest.
Pectus excavatum causes a child’s breastbone and ribcage to grow asymmetrically during puberty. This can put pressure on their chest and cause a sunken shape.
Is Pectus Excavatum Dangerous?
Pectus excavatum isn’t dangerous and doesn’t cause life-threatening complications. Occasionally, it can cause children to get tired very easily or be unable to exercise. Some families choose to repair pectus excavatum if the appearance or symptoms bother their child.
How Common Is Pectus Excavatum?
Pectus excavatum affects about 1 in 400 children. It’s three times more common in boys than in girls.
Pectus Excavatum vs. Pectus Carinatum
Pectus excavatum is when the chest has a sunken appearance. Pectus carinatum is when the chest juts outward. Another name for pectus carinatum is pigeon chest.
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Pectus Excavatum Causes
Children’s bones are mostly made of a strong tissue called cartilage before they go through puberty. Their bones harden and replace that cartilage during puberty. Pectus excavatum can occur when your child’s chest bones don’t grow evenly during this process.
Is Pectus Excavatum Genetic?
Pectus excavatum can run in families. But experts don’t know exactly why. They haven’t identified a specific gene change (mutation) that causes pectus excavatum.
Pectus Excavatum Symptoms
The main symptom of pectus excavatum is an indented appearance to the chest. This is the only symptom for many people.
Sometimes children have symptoms that affect their heart and lungs:
- Coughing or wheezing
- Difficulty tolerating exercise
- Rapid heartbeat
- Shortness of breath (dyspnea)
There’s no difference in pectus excavatum symptoms between males and females. The depth of the indentation doesn’t determine your child’s symptoms either. Experts don’t know exactly why some children have symptoms and others don’t.
Hear From Katie Russell, MD, and Brock, a Former Patient
Pectus Excavatum Diagnosis
Your child’s pediatric specialist may initially diagnose pectus excavatum based on a physical exam. They will also use a CT scan to get a closer look at how deep your child’s indentation is.
We may use other tests if your child has heart or lung symptoms:
- Allergy testing
- Echocardiogram
- Electrocardiogram
- Pulmonary function tests
- Stress test
Pectus Excavatum Treatment
The main treatment for pectus excavatum is surgery. Sometimes, we may discuss a nonsurgical treatment called vacuum bell therapy with you. We usually reserve this therapy for children who are too young to have surgery.
The best time to perform pectus excavatum surgery is while children are young teenagers. Your child’s bones mold more easily at this age because they aren’t fully hardened.
Many children grow into healthy, active adults without pectus excavatum surgery. The appearance or symptoms of pectus excavatum may bother other children. Surgery may be worth considering in these cases. Your child’s pediatric specialist can help you and your child weigh the pros and cons of surgery. They can help you make the decision that’s right for your child.
Pectus Excavatum Surgery
There are two main techniques for pectus excavatum surgery:
- Nuss procedure: We use the Nuss procedure, a minimally invasive surgery, for most children. Your child’s surgeon makes two small incisions on each side of your child’s chest. Then they insert a metal C-shaped bar through the incisions. They position the bar behind your child’s breastbone to help correct the depression in their chest. Your child’s bones grow around the bar into a more typical shape. The bar stays in place for three years. Then we remove it.
- Ravitch procedure: We rarely use the Ravitch procedure, which is an open surgery. Your child’s surgeon makes a large incision in your child’s chest and breastbone. They repair and reshape the chest with implanted bars. We only use this approach when pectus excavatum is very severe, which is rare.
After Surgery Instructions | Instrucciones Para Después de la Cirugía
Pectus Excavatum Surgery Recovery
Children usually miss about 1–2 weeks of school after pectus excavatum Nuss surgery. They will have some pain and discomfort while they heal. Our surgeons use a technique during surgery that freezes specific nerves to help numb them. This technique is called intercostal nerve cryoablation, and it can drastically reduce your child’s pain.
Children will need about 4–6 weeks to feel like participating in their usual activities. Full recovery takes 4–8 weeks. Ask your child’s surgeon if your child needs to follow any activity-specific restrictions during healing.
Why Choose University of Utah Health?
University of Utah specialists with the Utah Pectus Program treat more than 100 children with pectus excavatum each year. Our surgical team has extensive experience caring for children with this condition. We have the skills and technology to offer techniques that reduce your child’s hospital stay and create an easier recovery.
Make an Appointment
Call 801-662-2950 to schedule an appointment with our team. We don’t require referrals, but some insurance plans do. Our team will help you verify your insurance coverage before your child’s appointment.
