Abstract
Backgroud: Pectus excavatum, the most common congenital thoracic deformity, is particularly difficult to correct in adults with reduced chest wall flexibility. For the repair of pectus excavatum, we have conducted sterno-costal elevation, which consists of resecting the redundant costal cartilages and the lower part of the sternum and resuturing the remaining costal cartilages to the sternum, and does not use any exogenous materials or require a second operation. Methods: We treated a 27-year-old female patient with an asymmetrical chest concavity who was referred to us because of consistent precordial pain with sterno-costal elevation. In this case, we added an oblique osteotomy across the anterior sternal table to reform the torsion of the sternum with a pneumatic powered drill. Results: The procedure corrected the deformity well, and the patient was very satisfied with the result one year after the operation. Conclusions: Sterno-costal elevation for pectus excavatum, which does not require any exogenous materials or additional operations, is effective in the treatment of pectus excavatum in a female adult patient with a symmetrical chest deformity and moderate sternal torsion.
Highlights
Pectus excavatum (PE) is the most common thoracic deformity
We report the case of a 27-year-old female PE patient treated with stero-costal elevation (SCE) IV
[4] The correction of the chest wall is more difficult in adult PE patients than in younger PE patients because reduced chest wall flexibility in adult patients creates conditions where correcting the deformity requires more force [5]
Summary
Pectus excavatum (PE) is the most common thoracic deformity. The deformity is a congenital anomaly in which the body of the sternum is depressed to form a concavity, the depth of which is commonly maximal just above the xiphisternal junction. In adult PE patients with asymmetrical deformities, correction is quite difficult because the chest wall is less flexible than in younger patients. The procedure consists of resecting the redundant costal cartilages and the lower part of the sternum and resuturing the remaining costal cartilages to the sternum [3]. We have used our experience with real clinical cases to develop a modified SCE procedure (SCE IV) for adult PE patients with asymmetrical thoracic deformities and moderate torsion of the sternum. The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day The symmetry of her thorax remained intact one year after operation, making the patient very satisfied with the surgical result (Figure 3)
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