What Is Pectus Excavatum (Cobbler's Chest)?
Pectus excavatum, commonly known as cobbler's chest, is a chest wall deformity characterized by an inward depression of the sternum (breastbone). It is a congenital structural condition that usually becomes more noticeable during childhood or adolescence. It can cause both cosmetic and functional problems. In advanced cases, it may press on the heart and lungs and lead to shortness of breath, fatigue and cardiovascular problems.
Treatment Methods for Pectus Excavatum
Treatment is planned according to the severity of the deformity, the patient's age, symptoms and cosmetic expectations. Treatment options fall into two groups: surgical and non-surgical approaches.
1. Surgical Treatment
Surgery is the most effective treatment for pectus excavatum. The main techniques are:
- Nuss Procedure: A minimally invasive technique. A metal bar is placed inside the chest and pushes the sternum outward into its normal position. The bar is usually removed after 2-3 years. It leaves smaller scars and recovery is faster.
- Ravitch Procedure: A more invasive technique in which the chest wall is corrected with open surgery. It is preferred especially for severe deformities.
2. Non-Surgical Treatment
May be used at an early age and for mild deformities:
- Vacuum Bell: A vacuum device placed over the chest creates negative pressure that helps pull the sternum outward.
- Exercise and Physiotherapy: Exercises that strengthen the muscles supporting the chest wall may slow the progression of the deformity. However, this method cannot fully correct the deformity.
- 3D Braces: In some cases, specially designed braces can help improve the appearance of the deformity.
Symptoms of Pectus Excavatum
- Physical Appearance: The breastbone looks sunken inward.
- Shortness of Breath: Breathlessness felt especially during physical activity.
- Chest Pain: Some patients may experience pain in the chest area.
- Fatigue: Low energy may occur because the heart and lungs cannot expand adequately in the narrowed chest cavity.
- Psychological Effects: Self-confidence problems related to physical appearance may develop.
Treatment Decision and Process
Early diagnosis and evaluation by a specialist doctor are important in the treatment of pectus excavatum. The following are taken into account when planning treatment:
- The severity of the chest deformity (measured with the Haller Index)
- The effects on respiratory and heart function
- The patient's cosmetic concerns