"Pigeon chest" and "funnel chest": the mystery of chest deformity and the solution

In pediatric clinics, parents are often worried about their children's abnormal chest shape. Among them, "pigeon chest" and "funnel chest" are the two most common chest deformities in children. These names may sound humorous, but in fact, they cause considerable trouble to children's growth and development. This article will take you to a deeper understanding of the causes and consequences of these two chest deformities and provide you with practical coping strategies.

1. Chicken breast: the secret of sternum protrusion

Pigeon chest, as the name suggests, refers to the abnormal protrusion of the sternum forward, like the breast of a chicken or pigeon . This deformity not only affects the appearance, but may also have a profound impact on the physical and mental health of children.

Causes : The formation of pigeon chest is related to many factors, the most important of which is abnormal calcium and phosphorus metabolism. Insufficient vitamin D intake, insufficient ultraviolet radiation, and rapid growth can all lead to excessive growth of ribs and costal cartilage, which in turn causes pigeon chest. In addition, a small number of pigeon chest cases are related to family inheritance, and about 20% to 25% of patients have a family history of the disease.

Clinical manifestations : In the early stage of pectus carinatum, there is often no obvious compression symptom, but as the disease worsens, patients may experience repeated respiratory tract infections, asthma, poor activity endurance and other problems. More importantly, pectus carinatum will bring a heavy psychological burden to patients, leading to psychological problems such as inferiority and anxiety.

Coping strategies : For patients with mild pectus carinatum, conservative treatment can be tried, such as sunbathing, outdoor sports, etc., to promote bone development. Moderate to severe patients may need to wear an orthopedic vest to apply pressure to correct the protruding part of the central sternum. If conservative treatment is ineffective, or the deformity seriously affects cardiopulmonary function, surgical treatment can be considered, such as thoracoplasty, autologous cartilage transplantation, and modified NUSS orthopedic plate technology.

2. Pectus excavatum: the mystery of sternal depression

If pectus carinatum is the bulge of the sternum forward, then pectus excavatum is the depression of the sternum and its adjacent ribs toward the spine, which is shaped like a funnel , hence the name. This deformity also poses a serious threat to the physical and mental health of children.

Etiology : The cause of pectus excavatum has not been fully clarified, but most studies believe that it is a congenital malformation and has nothing to do with calcium deficiency. In addition, family inheritance is also an important factor in pectus excavatum, and about 10% to 20% of children have a family history.

Clinical manifestations : The anterior chest wall of patients with pectus excavatum will be concave inward, and in severe cases may even approach the spine. This deformity not only affects the appearance, but may also compress the heart and lungs, leading to decreased cardiopulmonary function, fatigue, shortness of breath, palpitations and other symptoms. As children's cognitive abilities improve, pectus excavatum may also cause psychological problems such as inferiority and anxiety.

Treatment timing : The treatment of pectus excavatum mainly relies on surgery. The best time for surgery varies from person to person, but it is generally recommended to be performed at the age of 3 years or older. For patients with mild symptoms that have little impact on daily life, the condition can be observed first; if the condition worsens during the peak growth period, timely surgical treatment is required.

Surgical progress : The surgical method for pectus excavatum has undergone many improvements, from the earliest removal of the deformed sternum, to cutting the deformed sternum and flipping it 180 degrees, to the later minimally invasive correction (such as NUSS surgery). Each progress has greatly reduced the surgical trauma and pain of the patient. At present, minimally invasive pectus excavatum correction has become the preferred surgical procedure. It uses small incisions on both sides of the chest wall, and inserts a special material orthopedic steel plate to support and raise the sternum with the assistance of thoracoscopy. There is no need to cut the sternum and ribs, with less trauma, quick recovery, and good correction effect.

3. From psychological to physiological: comprehensive treatment of chest deformity

Pectus carinatum and pectus excavatum not only affect children's growth and development and cardiopulmonary function, but may also cause serious psychological problems. Therefore, in the treatment process, we need to deal with it from all aspects, from psychological to physiological.

Psychological care : Because the change in body shape affects the appearance, children with chest deformity often have low self-esteem and are afraid of surgery and anesthesia. Medical staff should communicate with parents and children in a timely manner, introduce the indications, methods, advantages, etc. of the surgery, eliminate their anxiety and fear, and improve the success rate of the surgery.

Nutritional support : Some children with chest deformity have developmental delay and weak constitution due to compression of the heart, lungs and esophagus by the sternum. The nutritional status of the children should be assessed before surgery, and they should be guided to eat a high-protein, high-calorie, high-vitamin diet, such as meat, eggs, milk, and fresh fruits and vegetables. If necessary, intravenous infusion can be used to supplement energy and vitamins.

Postoperative care : After the operation is successful, postoperative care for the child is equally important. Parents should follow the doctor's advice to keep the child lying flat, choose a hard bed, avoid chest weight, etc. At the same time, encourage the child to practice effective coughing and deep breathing to strengthen lung function training. In terms of diet, the child should gradually transition from liquid and semi-liquid diet to normal diet, and strengthen nutritional support.

Rehabilitation exercise : Postoperative rehabilitation exercise is crucial for the recovery of children. It is generally recommended to start non-strenuous physical exercise, such as jogging, swimming, dancing, etc., 1 to 3 months after surgery. The amount of exercise should be gradually increased from small to large. Avoid strenuous exercise, such as running, playing basketball, playing football, etc. within 3 months. After half a year, the amount of exercise can basically be fully restored to the pre-operative level.

4. Prevention is better than cure: Pregnancy care and daily observation

Although pigeon chest and funnel chest are mostly congenital malformations, prenatal care and daily observation can still prevent or reduce their occurrence to a certain extent.

Pregnant women should receive regular prenatal checkups, which can help detect congenital chest deformities early. Use medications under the guidance of a doctor and avoid contact with toxic chemicals, radiation and other harmful substances. At the same time, maintain a good living habit and mentality to create favorable conditions for the healthy development of the fetus.

Daily observation : Parents should pay close attention to their children's growth and development. If they find abnormal chest shape or symptoms such as breathing difficulties, they should seek medical attention in time. After confirming the diagnosis through physical examination, chest imaging examination, etc., they should cooperate with the doctor for effective treatment.

Conclusion: Stand tall and embrace a bright future

Although pectus carinatum and pectus excavatum bring considerable challenges to children's growth, as long as we fully understand their causes, clinical manifestations and coping strategies, we can effectively deal with these chest deformities. Through professional medical intervention, scientific psychological care and comprehensive postoperative care, children will be able to hold their chests high and welcome a better future.

Let's work together to protect the growth of children! When facing chest deformities such as pectus carinatum and pectus excavatum, we should remain calm and rational, as well as loving and patient. I believe that with the continuous progress of medicine and the joint efforts of society, more and more children will be able to get rid of the troubles of these deformities and grow up healthily and happily.