Pei-Yeh Chang1, Qi Zeng2, Kin-Sun Wong3, Jin-Yao Lai1, Jeng-Chang Chen1, Chao-Jan Wang4, Chee-Jen Chang5. 1. Division of Pediatric Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan. 2. Department of Pediatric Surgery, Beijing Children Hospital, Capital Medical University, Beijing, China. 3. Department of Pediatrics, Chang Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan. 4. Department of Radiology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan. 5. Chang Gung Memorial Hospital, Resources Center for Clinical Research, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Abstract
BACKGROUND: We conducted a cross-sectional study to quantify the developmental changes of the thoracic cage in patients with pectus excavatum (PE). METHODS: The preoperative posteroanterior standing chest radiographs (chest PAs) of 1,197 consecutive patients with PE, together with 1,661 age- and sex-matched minor surgery patients, as a control group, who were seen between June 2005 and February 2013, were reviewed. The maximum width of each rib pair and chest height (H) were measured on the chest PA. RESULTS: In the PE group, the normal thoracic contour in younger patients was replaced by a characteristic can-shaped chest wall, which showed protrusion of the upper ribs, an increased H, and a straightened lateral border of the chest cage, as they grew into adulthood. The chest height difference between the PE and control groups increased progressively, from the age of 8 years and most significantly from age 13 to 17 years. No difference was observed in the middle and lower rib widths. Sex did not influence these trends. CONCLUSION: The PE chest wall shows a significant increment in chest height, and upper rib width starts during the period of rapid growth and is maintained into adulthood. The thoracic deformity in patients with PE includes more than just the sternal deformity. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: We conducted a cross-sectional study to quantify the developmental changes of the thoracic cage in patients with pectus excavatum (PE). METHODS: The preoperative posteroanterior standing chest radiographs (chest PAs) of 1,197 consecutive patients with PE, together with 1,661 age- and sex-matched minor surgery patients, as a control group, who were seen between June 2005 and February 2013, were reviewed. The maximum width of each rib pair and chest height (H) were measured on the chest PA. RESULTS: In the PE group, the normal thoracic contour in younger patients was replaced by a characteristic can-shaped chest wall, which showed protrusion of the upper ribs, an increased H, and a straightened lateral border of the chest cage, as they grew into adulthood. The chest height difference between the PE and control groups increased progressively, from the age of 8 years and most significantly from age 13 to 17 years. No difference was observed in the middle and lower rib widths. Sex did not influence these trends. CONCLUSION: The PE chest wall shows a significant increment in chest height, and upper rib width starts during the period of rapid growth and is maintained into adulthood. The thoracic deformity in patients with PE includes more than just the sternal deformity. Georg Thieme Verlag KG Stuttgart · New York.