Dorothy FarrarFunnel breast
The funnel chest (pectus excavatum) is the name given to a pathological deformation of the anterior rib cage. The chest sinks as a result of changes in the cartilage connections of the ribs and sternum. As a result, the front chest wall appears in the shape of a funnel.
What is a funnel breast ?
The funnel breast occurs relatively rarely. The resulting funnel can differ greatly in its severity in different affected persons. The sinking of the anterior chest can, depending on the severity of the deformity, lead to impaired heart and lung function. Physical posture also occurs, in which the shoulders hang and have an inclination forward. The abdomen can protrude and cause increased pressure in the abdomen.
Causes
The funnel breast is a congenital disease whose exact causes are largely uncertain. Previously, it was assumed that the deformation of the breast bone is caused or favored by a lack of vitamin D. Today, however, this theory is considered refuted in medicine. Instead, it is assumed that heredity plays a role in the formation of a funnel breast.
In many cases, the funnel intensifies during the growth phase during puberty. The funnel breast occurs frequently in combination with Marfan syndrome or Poland syndrome. Malpositions of the spine, such as kyphosis or scoliosis, can also be accompanied by a funnel breast.
Symptoms and course
Typical symptoms of the funnel breast:
- reduced performance
- low self-esteem
The funnel breast itself is not associated with a health risk in most cases. However, patients with a funnel breast are often affected by reduced performance, especially during sports or other physical exertion. The reasons for this are manifold and lie mainly in the effects on the heart, lungs and mental stress.
The heart is pressed depending on the severity of the funnel chest and has less space than a healthy chest. At rest, this fact is usually not noticeable. During physical exertion, however, the heart lacks the necessary space to increase the volume and meet the correspondingly increased demand. The result is tachycardia and shortness of breath in the patient. If the funnel breast is corrected, these impairments disappear.
Patients with funnel chest usually have a reduced lung volume. However, the decreased lung function is less relevant, as patients are primarily impaired by the impaired cardiac ejection volume. The psychological consequences of a funnel breast can sometimes be serious. Patients often suffer from low self-esteem due to the deformation of their chest. This can result in reduced performance and also lead to social avoidance behavior. Those affected often tend to lack contact and social withdrawal.
Diagnosis
The deformity of the chest is externally visible and usually begins during the first year of life. Until the end of the growth phase after puberty, the deformation usually increases steadily. With the help of magnetic resonance imaging, the expression of the funnel breast can be analyzed. Concomitant symptoms such as impaired function of the heart and lungs are checked with ECG, echocardiography and a lung function test. The spine must also be examined for other clinical pictures, for example by means of X-rays.
Treatment and therapy
A funnel breast can be treated with a variety of therapy methods. In the event that treatment is not (yet) planned, physiotherapy can alleviate the symptoms of malformation. Physiotherapy also strengthens the back muscles. Such measures reduce the secondary diseases associated with a funnel breast. However, they do not cause the deformation of the chest as such.
A correction of the funnel breast is possible by surgery, which can often be performed minimally invasively. The approximately two-hour operation is performed under general anesthesia. An individually adapted metal implant is inserted into the patient. The implant causes the patient’s sternum and ribs to grow into the natural position. Depending on the age of the patient, this metal bracket remains in the chest for several years. After the pubertal growth phase, it is removed in adolescents. The implant must never be removed too early, otherwise the funnel breast may form again. The operation to remove the temple takes only a few minutes. After the procedure, patients must use respiratory gymnastics and keep the physical load as low as possible.
Surgical correction of the funnel breast is fraught with possible complications. Most often, patients complain of postoperative pain, so painkillers become necessary. A relatively new method of treating the funnel breast is the regular use of a suction cup designed to slowly raise the chest. The suction cup is used for one hour per day for one to three years and could make surgery superfluous in the future.
Prevention
Pectus excavatum is a congenital malformation, which is why prevention is not possible. It occurs with a frequency of about 1:300 to 1:400 births. Boys are three times more likely to be affected by the disease than girls. In 35% of cases, funnel chest occurs in families.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.