Pectus Excavatum

Pectus excavatum, is a congenital chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall and sometimes described as “sunken” or “funnel” chest. Pectus excavatum is the most common type of congenital chest wall deformity occurs1 in 300-400 births, with male predominance (male-to-female ratio of 3:1). The condition is typically noticed at birth, and more than 90% of cases are diagnosed within the first year of life. Worsening of the chest’s appearance and the onset of symptoms are usually reported during rapid bone growth in the early teenage years. The appearance of the chest can be very disturbing to young teenagers. Problems with self-esteem and body image perception are frequently reported in teenaged patients. Psychologic disturbances are not unusual in older patients. The treatment options include Nuss procedure and Eckart Klobe Vacuum Bell device.


Eckart Klobe Vacuum Bell Device

Basically, the vacuum bell works by establishing a vacuum, of up to 15% below atmospheric pressure, above the patient’s chest in order to draw the sternum out into a more normal position. Whilst the immediate effects of the device are only temporary as the sternum will revert to its original position after usage, the continued usage of the device is believed to have a permanent impact on the position of the breastbone. Many patients have reported an improved appearance to the sternum after 2–3 years of regular usage. The rubber bell is placed onto the chest wall so that a seal is created, and a hand pump connected to the bell by an air tube is used to reduce pressure inside the bell to up to 15% below atmospheric pressure. The drop in pressure results in the sternum being lifted upwards and a temporary resolution of the deformity.








References

F Haecker and J Mayr., “The vacuum bell for treatment of pecus excavatum: an alternative to surgical correction.” Eur J Cardiothorac Surg 2006;29:557-561.









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