Surgery for Sunken Chest Improves Mental and Physical Function

Surgical repair of pectus excavatum can dramatically improve body image as well as physical and psychosocial functioning, claims a new study.

Researchers at the Eastern Virginia Medical School (Norfolk, VA, USA) assessed thoughts about body image and functioning in 264 patients, ranging in age from 8 to 21 years who underwent surgical repair, as well as 291 parents. A one-year follow-up survey was completed by 247 patients and 274 parents. Responses were rated on a scale of 1 to 4 on the Pectus Excavatum Evaluation Questionnaire, with higher scores indicating a less-desirable experience.

The study results showed that overall, 97% of patients thought that the surgery improved the appearance of their chest. Surgery was associated with a reduction in feelings of social self-consciousness and with an improved body image. The patients' mean body image score improved from 2.30 to 1.40, and the physical difficulty score from 2.11 to 1.37. The results of the parental survey indicated improvements in emotional difficulties (score improved from 1.81 to 1.24), social self-consciousness (2.86 to 1.33), and physical difficulties (2.14 to 1.32). The authors did not find a correlation between preoperative psychosocial functioning and objective pectus excavatum severity. The study was published in the December 2008 issue of Pediatrics.

"These results should prompt physicians to consider the physiologic and psychological implications of pectus excavatum just as they would any other physical deformity known to have such consequences," concluded lead author Robert Kelly, M.D.

Pectus excavatum (literally, "hollowed chest", sometimes referred to as cobbler's chest, sunken chest, funnel chest, or simply a dent in the chest) is the most common congenital deformity of the anterior wall of the chest, in which several ribs and the sternum grow abnormally, producing a caved-in or sunken appearance of the chest. It is usually present at birth and progresses during the time of rapid bone growth in the early teenage years, but in rare cases does not appear until the onset of puberty. Pectus excavatum is sometimes considered to be cosmetic, however it can also impair cardiac and respiratory function, as well as cause pain in the chest and back.

Related Links:
Eastern Virginia Medical School