Introduction
Funnel chest, medically known as pectus excavatum, is a relatively common chest wall deformity in children. It occurs when several ribs and the sternum grow abnormally, causing a caved - in or sunken appearance of the chest. This condition can not only affect a child's physical appearance but also potentially impact the function of the heart and lungs and lead to psychological and social problems. When it comes to treating funnel chest in children in Albany, finding the right hospital is crucial. In this article, we will explore the various aspects of funnel chest treatment and highlight some hospitals that are well - known for their expertise in handling this condition.
Understanding Funnel Chest in Children
Definition and Prevalence
Funnel chest is characterized by an indented or sunken sternum (the center of the rib cage). It affects between 1 in 300 and 1 in 500 adolescents, making it one of the most common chest deformities in children. Caucasian children and boys are more likely to develop this condition. The indentation may not be noticeable at birth and can become more severe during growth spurts, especially in the early teenage years when bones grow rapidly.
Causes
The exact cause of funnel chest is still not fully understood. However, researchers suspect that genes may play a significant role. While the majority of children with funnel chest don't have a family history, enough cases with a family link have been identified to prompt further genetic investigations. It can be either a result of a congenital defect or develop within the first few months of birth. In some mild cases, the condition may correct itself before the child turns three, but in more moderate and severe cases, it usually gets worse over time.
Symptoms
The symptoms of funnel chest vary depending on the age of the child and the severity of the condition. In infants, symptoms may include a hollow depression in the chest that can be broad and shallow, deep and narrow, or irregular, as well as more rapid breathing than normal. In older children, common symptoms are shortness of breath upon exertion or exercise, chest pain, a lateral curvature of the spine and absence of the curve of the upper back, hooked shoulders, and a broad, thin chest. In severe cases, the sternum and ribs can press on the heart and lungs, affecting their function, although this usually only occurs during extreme exercise.
Complications
Approximately 15 percent of children with funnel chest also develop scoliosis (curvature of the spine). It can also be associated with connective tissue disorders such as Marfan syndrome or Ehlers - Danlos syndrome (EDS), although these associations are rare. Additionally, the physical appearance of the chest can cause psychological and social problems for the child, especially during adolescence when body image becomes more important.
Treatment Options for Funnel Chest
Non - Surgical Treatments
For mild cases of funnel chest, non - surgical treatments may be sufficient. One such treatment is vacuum bell therapy. This therapy uses a device worn on the outside of the body that creates suction to lift the breastbone forward over time. It typically works best for younger children with mild pectus excavatum and flexible chest walls. The child needs to wear the device for a total of four hours every day, and the therapy usually takes at least two years, depending on the child's growth.
Physical therapy can also be beneficial. It focuses on improving posture and upper body strength, which can help to minimize the appearance of the funnel chest and reduce any associated pain or discomfort.
Surgical Treatments
In moderate and severe cases, surgery may be required to correct the funnel chest. The two most common surgical procedures are the Nuss procedure and the Ravitch technique.
- Nuss Procedure: This is a minimally invasive procedure. Surgeons make two incisions on either side of the chest and insert a curved steel bar under the sternum. The bar is then flipped so that it pushes the sternum outward. The bar usually stays in the body for about two to three years. When the bones have solidified into place, the bar is removed during a same - day operation. This procedure is more popular because it requires much smaller incisions and is less invasive compared to other methods.
- Ravitch Technique: In this open - surgery approach, the surgeon makes an incision along the chest, removes the cartilage that is causing the abnormal growth, and detaches the sternum. A small bar is then implanted beneath the sternum to raise and hold it in the desired position. The bar is left in place until the cartilage grows back and can support the chest in a normal position, which usually takes about one to two years. The bar is then removed during a same - day operation.
Hospitals in Albany for Treating Funnel Chest in Children
Albany Med Health System
The Albany Med Health System's pediatric pulmonary and cystic fibrosis center offers comprehensive care for children with various respiratory and lung disorders. While their primary focus on respiratory conditions may seem unrelated to funnel chest at first glance, they play a crucial role in the pre - operative and post - operative care of children with funnel chest. Funnel chest can affect the function of the lungs, and the center's expertise in pulmonary function testing, such as spirometry and exercise evaluations, is essential for assessing the impact of the condition on the child's breathing. Their team of pediatric pulmonary specialists can work in collaboration with cardiothoracic surgeons to provide a multidisciplinary approach to treatment. The center also conducts research on pulmonary complications in children, which may contribute to a better understanding of how funnel chest affects the respiratory system and how to optimize treatment.
Services Offered:
- Pulmonary function testing to assess the impact of funnel chest on lung function.
- Medical management of any associated respiratory conditions, such as asthma or breathing disorders, which may be exacerbated by the funnel chest.
- Education and counseling for families to help them understand the condition and its management.
Other Reputable Children's Hospitals Outside Albany with Funnel Chest Expertise
Although the focus is on Albany, it's worth mentioning some well - known children's hospitals outside the area that are leaders in treating funnel chest in children. These hospitals have a long - standing reputation for excellence in pediatric surgery and multidisciplinary care, and their approaches can serve as a reference for what to expect in terms of treatment quality.
SSM Health Cardinal Glennon Children's Hospital
SSM Health Cardinal Glennon uses a multidisciplinary approach for treating chest wall deformities, including funnel chest. Their SLUCare physician group team, which includes cardiothoracic surgeons, pediatric surgeons, and orthopedists, work together to develop the best care plan for each child. This comprehensive approach ensures that all aspects of the child's health, including the heart, lungs, and skeletal system, are considered during the treatment process. They also take into account the long - term growth and development of the child when making treatment decisions. For milder cases, they may recommend non - invasive or conservative treatments, while in more severe cases, they are experienced in performing surgical procedures like the Nuss or Ravitch procedures.
CHOC - Children's Hospital of Orange County
CHOC's Pectus Treatment Program is a leading provider for pectus care, including funnel chest. Their experienced pediatric chest wall experts use leading - edge pectus procedures focused on reducing recovery time. The program brings together a multidisciplinary team of pediatric experts, including pediatric pulmonologists, cardiologists, pediatric anesthesiologists, pediatric thoracic surgeons, and patient mentors. They assign two surgeons to every case, which sets a high standard in treatment safety and efficacy. Their innovative Nuss procedure allows around 65% of patients to be discharged from the hospital on the same day as their surgery. They also have a coordinated pectus patient care system, with a pectus program coordinator who helps families with all aspects of the treatment process, from arranging medical care to travel plans.
Boston Children's Hospital
Boston Children's Hospital's Pectus and Chest Wall Treatment Program evaluates and treats infants, children, and young adults using state - of - the - art operative and non - operative methods. They usually start with non - surgical treatment, such as vacuum bell therapy, and only recommend surgery if it is the only option to correct the shape of the chest. When surgery is required, their surgeons prefer to operate during a child's teen years and use advanced techniques such as cryoablation for pain management, which has been proven to reduce the length of hospital stay, decrease the need for pain medication, and improve recovery times. The hospital also offers extensive resources and can coordinate treatment for other associated conditions, such as scoliosis or connective tissue disorders.
Factors to Consider When Choosing a Hospital for Funnel Chest Treatment
Expertise of the Medical Team
The expertise of the medical team is of utmost importance. Look for hospitals that have a team of experienced cardiothoracic surgeons, pediatric surgeons, orthopedists, pulmonologists, and cardiologists. These specialists should have a proven track record in treating funnel chest in children. Check their credentials, experience in performing the specific surgical procedures (if surgery is required), and their research contributions to the field.
Multidisciplinary Approach
Funnel chest treatment often requires a multidisciplinary approach. A hospital that can bring together different specialists to collaborate on a child's care is more likely to provide comprehensive and effective treatment. This includes not only medical treatment but also psychological support for the child and their family, as the condition can have a significant impact on the child's self - esteem and mental well - being.
Available Treatment Options
Ensure that the hospital offers a range of treatment options, from non - surgical treatments like vacuum bell therapy and physical therapy to surgical procedures such as the Nuss and Ravitch techniques. Having multiple treatment options allows the medical team to tailor the treatment to the specific needs and severity of the child's condition.
Success Rates and Patient Outcomes
Research the hospital's success rates in treating funnel chest. Success can be measured in terms of the correction of the chest deformity, improvement in the child's physical symptoms (such as breathing and chest pain), and long - term outcomes. Look for patient testimonials and outcomes data to get an idea of how well the hospital has treated similar cases.
Support Services
Consider the support services offered by the hospital. This includes things like patient education, family support groups, and post - operative rehabilitation services. These services can play a crucial role in the child's recovery and the family's ability to cope with the treatment process.
Preparing for Funnel Chest Treatment
Initial Consultation
During the initial consultation, the medical team will conduct a thorough physical examination of the child, including chest measurements and photographs. They may also order additional tests, such as x - rays, echocardiograms, pulmonary function tests, or MRIs, to assess the severity of the funnel chest and its impact on the heart and lungs. Be prepared to provide a detailed medical history of the child, including any family history of similar conditions.
Understanding the Treatment Plan
After the evaluation, the medical team will discuss the treatment plan with you. They will explain the benefits and risks of each treatment option, whether it's non - surgical or surgical. Make sure you have a clear understanding of the treatment process, the expected recovery time, and any potential complications. Ask questions if there is anything you don't understand.
Pre - operative Preparation (if applicable)
If surgery is recommended, there will be a pre - operative preparation period. This may include blood tests, a physical examination, and discussions with the anesthesiologist. The child may need to stop taking certain medications before the surgery. You will also receive instructions on how to prepare the child for the surgery, such as fasting requirements on the day of the operation.
Recovery and Follow - up Care
Immediate Post - operative Recovery
The immediate post - operative recovery period varies depending on the surgical procedure. In the case of the Nuss procedure, the immediate recovery time in the hospital is usually four to five days. During this time, the child will be closely monitored for pain, bleeding, and any signs of complications. Pain management is an important part of the recovery process, and the medical team will use a combination of medications and advanced techniques, such as cryoablation, to keep the child comfortable.
Resuming Normal Activities
Most children can return to school in two to three weeks after surgery, but they will have exercise restrictions for about 12 weeks. Regular activity can usually resume after full recovery, which is typically at around three months. The child will also need to wear a support brace or garment for a certain period to help with the healing process and maintain the corrected shape of the chest.
Follow - up Appointments
Follow - up appointments are crucial to monitor the child's progress. The medical team will check the healing of the incisions, the position of the bar (if a surgical procedure was performed), and the overall improvement in the chest deformity. They will also assess the child's lung function and address any concerns or questions you may have. These appointments may continue for several years after the surgery to ensure long - term success.
Conclusion
Treating funnel chest in children is a complex process that requires careful consideration and the expertise of a qualified medical team. In Albany, the Albany Med Health System's pediatric pulmonary and cystic fibrosis center provides important services related to the respiratory aspects of funnel chest treatment. While looking for a hospital for your child's funnel chest treatment, consider factors such as the expertise of the medical team, the multidisciplinary approach, available treatment options, success rates, and support services. Outside of Albany, hospitals like SSM Health Cardinal Glennon Children's Hospital, CHOC, and Boston Children's Hospital are renowned for their excellence in treating funnel chest. By making an informed decision and working closely with the medical team, you can ensure the best possible outcome for your child's treatment. If you suspect your child has funnel chest, don't hesitate to schedule a consultation with a qualified pediatric specialist to discuss the next steps.
Take action now! If you have any concerns about your child's chest development, reach out to a hospital in Albany or one of the well - known children's hospitals mentioned above. Schedule a consultation to get a professional evaluation and start exploring the treatment options available for your child.
