Risks and Benefits of Pectus Excavatum Treatments for Adults

Pectus excavatum is usually perceived as a childhood deformity affecting the chest wall and its surrounding tissue. Usually, the condition is diagnosed as a child enters toddlerhood, but in some cases, the congenital disability doesn’t present itself until it hits adolescence.

The condition can vary from patient to patient. Some face many difficulties, such as lung and chest problems and breathing difficulties, while others just have a slightly concave chest appearance. Click here to read more about the condition and how it can affect you.

Pectus Excavatum in Adults

In most cases in the US, pectus excavatum is diagnosed and treated in childhood or young adulthood. There are many reasons behind this haste in treatment, the primary reason being the malleable nature of children’s bones and chest walls. But that’s not always the case. There can be multiple reasons why some adults may present with untreated pectus excavatum, such as

1. Medical Advancements

Medical science has come a long way in the past few years. Advancements have been made both in surgical techniques and pharmaceuticals. Paving the way for many new treatment possibilities and changing the way medical intervention takes place. 

2. Underlying Conditions

Certain pre-existing medical conditions can make the child an unsuitable candidate for surgical correction of pectus excavatum. Such as blood disorders or connective tissue disorders. Such conditions make surgery riskier for the child; hence the condition is left untreated till adulthood.

3. Lack of Excess to Medical Facilities

The availability of medical facilities is not the same across the globe. Many children growing up in less privileged parts of the world only learn about their condition as adults.

4. Worsening of Condition in Adulthood

In some cases, symptoms of pectus excavatum exacerbate in adulthood. Even if the patient’s experience has been relatively smooth in adolescence and childhood.

Treatment Options

Treatment options for adult pectus excavatum are limited compared to the treatment of the condition in children. The reason is that growing bones are more flexible than adult bones that have entirely formed. So treatment options like bracing or vacuum bell therapy can’t be used to treat pectus excavatum in adults.

In mild to severe cases, surgery can be used to rectify the condition in adults. Here are the two procedures used most commonly to correct pectus excavatum:

Ravitch Procedure

The Ravitch procedure is also called open repair because it’s a highly invasive surgery to fix sunken chest syndrome. It's only used in the most extreme cases of pectus excavatum when all other options are deemed unsuitable. 

The surgeon makes a horizontal cut on the patient’s chest to remove the excess chest tendons. The chest wall is then moved into the optimal position for the chest to retain a more normal appearance. A metal bar is sometimes inserted in the chest to ensure the chest wall maintains its position.

Nuss Procedure

The Nuss procedure is relatively less invasive than the Ravitch procedure. An arched metal bar is used in this procedure called the pectus bar. The curvature of the bar is adjusted depending on the shape of the patient’s chest. The bar is placed across the rib cage and gently propels the sternum forward over the coming months. 

Once the bar is in the optimal position, it’s screwed into the chest wall before closing up the patient’s chest.

Using an endoscope makes the procedure safer by ensuring no accidental damage is done to any major organs during the surgery. It also guides the surgeon and makes the procedure less invasive than the Ravitch Procedure.

Risks of Receiving Pectus Excavatum Treatment as an Adults

All major surgeries carry risks for the patient. All surgical procedures done to correct pectus excavatum are no different. Surgery is used only as a last resort or when other treatment options have failed.

Surgical correction is often avoided and postponed for children with the condition. But for adult patients, it’s often the only treatment course. Here are some of the risks of all pectus excavatum-related surgeries:
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• Pain
• Infection
• Bone fracture
• Excessive bleeding
• Injury to the heart or lungs
• Lung puncture leading to lung collapse
• Permanent or temporary nerve damage
• Reaction to the bar placed during surgery
• Damage caused by migration of the metal bar
• Reversal of the condition after the bar is removed
• Chronic discomfort due to the presence of the pectus bar
  
  

Benefits of Correcting Pectus Excavatum

Before we discuss the benefits that a patient stands to gain from the surgical correction of pectus excavatum, it’s essential to understand that the condition affects patients both internally and externally. While issues such as reduced heart and lung function are of concern, the psychological effects of the malformation should not be ignored when deciding on a treatment plan.

In most cases, the Nuss and the Ravitch Procedure have shown excellent results in correcting pectus excavatum in adults. Provided there are no underlying conditions or complications during surgery.

Quality of life and patient satisfaction  also improves in most adults that undergo surgery. Most patients report having more energy and stamina, reduced shortness of breath, and a clear improvement in the appearance of their chest. The improved sports endurance can be attributed to improved heart and lung functions previously affected by pectus excavatum. 

Chronic chest pain also got resolved for many patients after healing from surgery.

Almost all adult patients report improved confidence and self-image after successfully reversing pectus excavatum. The betterment in their chest appearance seems to affect their body image and quality of life positively.

Is Pectus Excavatum Surgery Right for You?

Dealing with pectus excavatum can be a challenge at any stage of life. Our doctors at Align Clinic have helped many patients just like you. Contact us today to discuss treatment options and see if you’re eligible for surgical correction.