Pectus Carinatum
What is Pectus Carinatum?
Deformities in which the chest wall is not sunken inward but protrudes outward, are called pectus carinatum deformity. This deformity is rarer than pectus excavatum. It usually does not cause a decrease in heart or lung functions. This treatment is primary need due to the patient’s unhappiness with his/her appearance.
Treatment of Pectus Carinatum
Pectus Cariantum treatment is surgical, just like that of pectus excavatum deformity. Similarly, a steel bar placed under the skin with the minimally invasive - MIRPC procedure (Abramson Procedure) can collapse the chest wall and bring it to its normal position or sternum bone is disconnected from the cartilage by making a big incision with the Ravitch procedure and the cartilage can be shortened if necessary. The difference of the Abramson procedure from the Nuss procedure performed for patients with pectus excavatum is that it does not access the chest cavity, and the bar is transported over the bone. Therefore, serious complications such as heart injuries are not observed.
The use of orthoses comes to the forefront in non-surgical treatment. The deformity is improved by applying constant pressure to the protruding area with an orthosis, while allowing for the development of the other parts. For orthotic treatment, there are treatment approaches that include 23 hours, 18 hours, 12 hours or 6 hours of application per day.
The longer the daily application period involved by the approach, the sooner the results can be obtained. However, this depends on the patient's social life. It would be appropriate to perform the procedure in an experienced medical center, where this procedure has been performed in a large number of cases, in order to be able to select the appropriate orthosis, to ensure that the orthosis has been produced of a suitable material, to prevent potential development of Pectus Excavatum during the use of the orthosis, and to closely monitor the patient properly. Patients should be monitored at certain intervals, in order to determine how long the treatment should be continued, when it should be paused until the the bones harden, and when it can be repeated.
In the selection good candidates for orthotic treatment, it is necessary to make sure that the chest wall has yet to harden. Therefore, it is applied to patients under 17 years of age. Measurement should be made to see under how much pressure the patients' deformities improve, and a surgical procedure should be chosen without applying an orthosis for patients who need a pressure above a certain value. In addition, if the pressure required for correction decreases compared to the pressure measured in the previous inspection even if the images of the patient do not show improvement during the control examinations, it means that the treatment of the patient is on the right track and visual results will also be obtained by continuing the treatment. This prevents unnecessarily quitting the treatment.
