Abstract
Chest wall deformities are classified according to their anatomic topography based on the area of involvement sternum, cartilage or ribs. Each of these structures encompasses a wide range of pathologies, with some pathological conditions such as pectus excavatum and pectus carinatum occurring more frequently than others. Although the anatomic topographic classification groups the deformities based on their origin, another classification has been provided based on the type of deformity – ranging from mild to severe, with an algorithm towards management which ranges from “wait and watch” to performing of complex surgical procedures. Attention has been paid to the most commonly occurring chest wall deformities- pectus excavatum and pectus carinatum and their combinations. The chapter enlists a wide range of other clinical conditions associated with chest wall deformities.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Saxena AK. Pectus excavatum: changing scenario to evaluation and treatment. VIIth Congress of the Mediterranean Association of Pediatric Surgery, 9–11 Oct 2008, Tunis
Schier F, Bahr M, Klobe E. The vacuum chest wall lifter; an innovative, nonsurgical addition to the management of pectus excavatum. J Pediatr Surg. 2005;40:496–500.
Martinez-Ferro M, Fraire C, Bernard S. Dynamic compression system for the correction of pectus carinatum. Semin Pediatr Surg. 2008;17:194–200.
Acastello E, Majluf F, Garrido P, Barbosa LM, Peredo A. Sternal cleft: a surgical opportunity. J Pediatr Surg. 2003;38:178–83.
Forzano F, Daubeney P, White SM. Midline raphe, sternal cleft, and other midline abnormalities: a new dominant syndrome? Am J Med Genet A. 2005;135:9–12.
Shamberger R, Welch K. Sternal defects. Pediatr Surg Int. 1990;5:156–64.
Torre M, Rapuzzi G, Carlucci M, Pio L, Jasonni V. Phenotypic spectrum and management of sternal cleft: literature review and presentation of a new series. Eur J Cardiothorac Surg. 2012;41:4–9.
Willital GH, Maragakis MM, Schaarschmidt K, et al. Indikation zur Behandlung der Trichterbrust. Dtsch Krankenpfleger Zeitsch. 1991;6:418–23.
Willital GH, Saxena AK, Schütze U, Richter W. Chest-deformities: a proposal for a classification. World J Pediatr. 2011;7:118–23.
Fokin AA, Steuerwald NM, Ahrens WA, Allen KE. Anatomical, histologic and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg. 2009;21:44–57.
Lopushinsky SR, Fecteau AH. Pectus deformities: a review of open surgery in the modern era. Semin Pediatr Surg. 2008;17:201–8.
Creswick HA, Stacey MW, Kelly RE, Gustin T, Nuss D, Harvey H, Goretsky MJ, Vasser E, Welch JC, Mitchell K, Proud VK. Family study on the inheritance of pectus excavatum. J Pediatr Surg. 2006;41:1699–703.
Haje SA, Harcke HT, Bowen JR. Growth disturbance of the sternum and pectus deformities: imaging studies and clinical correlation. Pediatr Radiol. 1999;29:334–41.
Kelly RE. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg. 2008;17:181–93.
Feng J, Hu T, Liu SW, Zhang S, Tang Y, Chen R, Jiang X, Wei F. The biochemical, morphologic, and histochemical properties of the costal cartilages in children with pectus excavatum. J Pediatr Surg. 2001;36:1770–6.
Haller JA, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg. 1987;22:904–6.
Colombani P. Preoperative assessment of chest wall deformities. Semin Thorac Cardiovasc Surg. 2009;21:58–63.
Saxena AK, Willital GH. Valuable lessons from two decades of pectus repair with the Willital-Hegemann procedure. J Thorac Cardiovasc Surg. 2007;134:871–6.
Peña A, Perez L, Nurko S, Dorenbaum D. Pectus carinatum and pectus excavatum: are they the same disease? Am Surg. 1981;47:215–8.
Kotzot D, Schwabegger AH. Etiology of chest wall deformities – genetic review for the treating physician. J Pediatr Surg. 2009;44:2004–11.
Williams AM, Crabbe DC. Pectus deformities of the anterior chest wall. Paediatr Respir Rev. 2003;4:237–42.
Currarino G, Silverman FN. Premature obliteration of the sternal sutures and pigeon-breast deformity. Radiology. 1958;70:532–40.
Swanson JW, Colombani PM. Reactive pectus carinatum in patients treated for pectus excavatum. J Pediatr Surg. 2008;43:1468–73.
Glass RB, Norton KI, Mitre SA, Kang E. Pediatric ribs: a spectrum of abnormalities. Radiographics. 2002;22:87–104.
Panegyres PK, Moore N, Gibson R, Rushworth G, Donaghy M. Thoracic outlet syndromes and magnetic resonance imaging. Brain. 1993;116:823–41.
Willich E, Richter E. The thorax. In: Ebel KD, Blickman H, Willich E, Richter E, editors. Differential diagnosis in pediatric radiology. New York: Thieme; 1999. p. 124–34.
Edwards 3rd DK, Berry CC, Hilton SW. Trisomy 21 in newborn infants: chest radiographic diagnosis. Radiology. 1988;167:317–8.
Tahernia AC, Stamps P. “Jeune syndrome” (asphyxiating thoracic dystrophy). Report of a case, a review of the literature, and an editor’s commentary. Clin Pediatr (Phila). 1977;16:903–8.
Wynne-Davies R, Hall CM, Apley AG. Atlas of skeletal dysplasias. London: Churchill Livingstone; 1985. p. 304–8.
Gayler BW, Donner MW. Radiographic changes of the ribs. Am J Med Sci. 1967;235:588–619.
Gorlin RJ, Goltz RW. Multiple nevoid basal-cell epithelioma, jaw cysts and bifid rib: a syndrome. N Engl J Med. 1960;262:908–12.
Hunt JC, Pugh DG. Skeletal lesions in neurofibromatosis. Radiology. 1961;76:1–19.
Poznanski AK, Fernbach SK, Berry TE. Bone changes from prostaglandin therapy. Skeletal Radiol. 1985;14:20–5.
Kleinman PK, Marks SC, Spevak MR, Richmond JM. Fractures of the rib head in abused infants. Radiology. 1992;185:119–23.
Guest JL, Anderson JN. Osteomyelitis involving adjacent ribs. JAMA. 1978;239:133.
Teitelbaum SL. Twenty years’ experience with intrinsic tumors of the bony thorax at a large institution. J Thorac Cardiovasc Surg. 1972;63:776–82.
Shamberger RC, Laquaglia MP, Krailo MD, et al. Ewing sarcoma of the rib: results of an intergroup study with analysis of outcome by timing of resection. J Thorac Cardiovasc Surg. 2000;119:1154–61.
Schwartz HS, Zimmerman NB, Simon MA, Wroble RR, Millar EA, Bonfiglio M. The malignant potential of enchondromatosis. J Bone Joint Surg Am. 1987;69:269–74.
Bovee JV, Van Roggen JF, Cleton-Jansen AM, Taminau AH, Van Der Woude HJ, Hogedoorn PC. Malignant progression in multiple enchondromatosis (Ollier’s disease): an autopsy-based molecular genetic study. Hum Pathol. 2000;31:1299–303.
Guttentag AR, Salwen JK. Keep your eyes on the ribs: the spectrum of normal variants and diseases that involve the ribs. Radiographics. 1999;19:1125–42.
Uchida K, Kurihara Y, Sekiguchi S, et al. Spontaneous haemothorax caused by costal exostosis. Eur Respir J. 1997;10:735–6.
Resnick D. Lipoidoses, histiocytoses, and hypoproteinemias. In: Resnick D, editor. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia: Saunders; 1995. p. 2215–7.
Bertoni F, Unni KK, McLeod RA, Sim FH. Xanthoma of bone. Am J Clin Pathol. 1988;90:377–84.
Moser Jr RP, Davis MJ, Gilkey FW, et al. Primary Ewing sarcoma of rib. Radiographics. 1990;10:899–914.
Schulman H, Newman-Heinman N, Kurtzbart E, Maor E, Zirkin H, Laufer L. Thoracoabdominal peripheral primitive neuroectodermal tumors in childhood: radiological features. Eur Radiol. 2000;10:1649–52.
Freire-Maia N, Chautard EA, Opitz JM, Freire Maia A, Quelce-Salgado A. The Poland syndrome – clinical, and genealogical data, dermatoglyphic analysis, and incidence. Hum Hered. 1973;23:97–104.
Baban A, Torre M, Bianca S, Buluggiu A, Rossello MI, Calevo MG, Valle M, Ravazzolo R, Jasonni V, Lerone M. Poland syndrome with bilateral features: case description with review of the literature. Am J Med Genet A. 2009;149A:1597–602.
Karnak I, Tanyel FC, Tunçbilek E, Unsal M, Büyükpamukçu N. Bilateral Poland anomaly. Am J Med Genet. 1998;75:505–7.
Bavinck JNB, Weaver DD. Subclavian artery supply disruption sequence: hypothesis of a vascular etiology for Poland, Klippel-Feil and Mobius anomalies. Am J Med Genet. 1986;23:903–18.
Happle R. Poland anomaly may be explained as a paradominant trait. Am J Med Genet. 1999;87:364–5.
van Steensel MA. Poland anomaly: not unilateral or bilateral but mosaic. Am J Med Genet. 2004;125A:211–2.
Parker DL, Mitchell PR, Holmes GL. Poland-Moebius syndrome. J Med Genet. 1981;18(4):317–20.
Alexander A, Fokin MD, Robicsek F. Poland’s syndrome revisited. Ann Thorac Surg. 2002;74:2218–25.
Shamberger RC, Welch KJ, Upton III J. Surgical treatment of thoracic deformity in Poland’s syndrome. J Pediatr Surg. 1989;24(8):760–5.
Kaplan L, Barzilay Y, Hashroni A, Itshayek E, Schroeder JE. Thoracic elongation in type III osteogenesis imperfecta patients with thoracic insufficiency syndrome. Spine (Phila Pa 1976). 2013;38:E94–100.
Kansal R, Mahore A, Kukreja S. Jarcho-Levin syndrome with diastematomyelia: A case report and review of literature. J Pediatr Neurosci. 2011;6:141–3.
Willis J, Rosman NP. The Aicardi syndrome versus congenital infection: diagnostic considerations. J Pediatr. 1980;96:235–9.
Klippel M, Feil A. Un cas d’absence des vertebres cervicales. Avec cage thoracique remontant jusqu’a la base du crane (cage thoracique cervicale). Nouv Iconog Salpetriere. 1912;25:223–50.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Saxena, A.K. (2017). Classification of Chest Wall Deformities. In: Saxena, A. (eds) Chest Wall Deformities. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53088-7_2
Download citation
DOI: https://doi.org/10.1007/978-3-662-53088-7_2
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-53086-3
Online ISBN: 978-3-662-53088-7
eBook Packages: MedicineMedicine (R0)