Introduction

Pectus excavatum, commonly known as "sunken chest," is a prevalent chest - wall malformation in children. It can have a significant impact on a child's physical health, such as causing issues with breathing, reduced exercise tolerance, and in severe cases, affecting the heart and lung functions. Additionally, it can also cause psychological distress for the children, especially during adolescence. In New York City, there are several top - notch hospitals that offer high - quality treatment for this condition. This article aims to present the top ten hospitals for treating pectus excavatum in children in New York City, based on various factors like expertise, facilities, and success rates.

Understanding Pectus Excavatum in Children

What is Pectus Excavatum?

Pectus excavatum is a congenital deformity where the sternum and rib cartilages grow abnormally, causing the breastbone to sink inward. It often becomes more noticeable during puberty as the body grows. The main cause of pectus excavatum is not well - understood, but it is believed to have a genetic component. The condition can vary in severity, from mild cases where there are no obvious symptoms to severe cases that lead to breathing difficulties, chest pain, and a reduced quality of life. According to some studies, pectus excavatum occurs in approximately one out of 1,000 children, and it is about five times more common in boys than girls.

Symptoms and Complications

Young children with pectus excavatum may show no symptoms at all. However, as they grow, especially during puberty, the following symptoms may appear:

• Shortness of breath, particularly during physical exertion.
• Chest pain, usually at the front of the chest.
• Early fatigue during exercise.
• Poor posture, such as slumped shoulders and a protruding abdomen.

In severe cases, the sinking of the sternum can compress the heart and lungs, leading to more serious complications. The heart may be shifted to the left side of the chest, and the lungs may have reduced capacity, which can affect the child's overall physical performance and long - term health.

Diagnosis

Doctors usually start the diagnosis by conducting a physical examination. They will visually inspect the chest and look for signs of the characteristic sunken appearance. To measure the severity of the condition, doctors may use imaging techniques such as chest X - rays (both front and side views) or a chest CT scan. The Haller index, calculated from the CT scan, is a commonly used measure. A normal ratio of width - to - depth is about 2.5 to 1, and any calculation greater than 3.25 is considered a moderate to severe defect. In addition to these, pulmonary function tests may be done to check lung capacity, and an echocardiogram can be used to assess the heart's function and structure.

Top Ten Hospitals for Treating Pectus Excavatum in Children in New York City

New York - Presbyterian Morgan Stanley Children's Hospital

As part of Columbia Surgery, New York - Presbyterian Morgan Stanley Children's Hospital has a highly - regarded pediatric surgery program. It is ranked #1 among children's hospitals in New York by US News and World Report and is one of the only designated level 1 pediatric surgery centers in the Northeast, according to the American College of Surgeons. The hospital takes a comprehensive approach to pediatric surgical care, working closely with partners in pediatric anesthesiology, neonatology, and all pediatric medical subspecialties.

For pectus excavatum treatment, the surgeons use minimally - invasive techniques whenever possible. This means smaller incisions, less discomfort, shorter healing times, and less - noticeable scarring. The hospital has surgeons with extensive experience in dealing with chest wall abnormalities, and they frequently work alongside orthopedic surgeons and other specialists to ensure the best results. Parents can be involved in their child's surgical journey to a great extent, with parental visiting 24 hours a day and parental rooming - in available. To get started with the pediatric surgery program, families can call (212) 342 - 8585 or request an appointment online.

New York - Presbyterian Children’s Hospital - Columbia and Cornell

This hospital is nationally ranked in 10 pediatric specialties. It offers a wide range of advanced medical services for children. With a team of highly skilled pediatric surgeons, it provides excellent care for children with pectus excavatum. The hospital is associated with top - notch medical research and is at the forefront of developing new treatment methods. It also has a well - established patient support system that can help families deal with the emotional and practical aspects of their child's treatment.

Cohen Children's Medical Center

Cohen Children's Medical Center in New Hyde Park, NY, is nationally ranked in 8 pediatric specialties. It has a dedicated pediatric surgical team that is experienced in treating various pediatric conditions, including pectus excavatum. The hospital emphasizes patient - centered care, focusing on the well - being of the child and the comfort of the family. It has state - of - the - art facilities and offers both surgical and non - surgical treatment options for pectus excavatum, depending on the severity of the condition.

Mount Sinai Kravis Children's Hospital

Mount Sinai Kravis Children's Hospital in New York is nationally ranked in 4 pediatric specialties. The hospital's pediatric surgery department has a team of experts who are well - versed in treating pectus excavatum. They stay updated with the latest research and techniques in the field, ensuring that children receive the most appropriate and effective treatment. The hospital also provides comprehensive post - operative care to ensure a smooth recovery for the children.

Children's Hospital at Montefiore

Located in the Bronx, NY, the Children's Hospital at Montefiore is nationally ranked in 3 pediatric specialties. It offers a multidisciplinary approach to treating pectus excavatum, involving pediatric surgeons, cardiologists, pulmonologists, and other specialists. This collaborative approach ensures that all aspects of the child's health are considered during the treatment process. The hospital has a long - standing reputation for providing high - quality pediatric care in the New York area.

Hassenfeld Children’s Hospital at NYU Langone

Hassenfeld Children’s Hospital at NYU Langone in New York is nationally ranked in 3 pediatric specialties. The hospital's team of doctors is dedicated to providing the most advanced, personalized care for children with pectus excavatum. They offer a range of treatment options, from minimally invasive surgeries to more complex procedures when necessary. The hospital also has a strong focus on research, which helps in the development of new and improved treatment methods.

Johns Hopkins Children's Center (with NY affiliate considerations)

Although not located directly in New York, Johns Hopkins Children's Center has a significant influence in the medical field and may have affiliates or partnerships in New York. The pectus program at Johns Hopkins Children's Center comprises one of the most experienced pediatric surgical teams in the country specializing in treatment for chest wall deformities. It has a long - standing history in pectus excavatum treatment. Johns Hopkins was once the home of Mark Ravitch, who perfected the original open repair of pectus excavatum that bears his name. The center was also where Alex Haller introduced the Haller index, which is now used worldwide to evaluate pectus patients. Their modified Nuss procedure has allowed for decreased complications and excellent clinical results.

UCLA Mattel Children's Hospital (with possible NY referrals)

UCLA Mattel Children's Hospital is a leading center for treating chest deformities. While it is based in California, it may have referral networks in New York. The hospital usually recommends surgical correction of chest deformities during early adolescence to reduce the chance of recurrence. They offer two main surgical procedures for pectus excavatum: the Ravitch procedure (open or modified) and the Nuss procedure (minimally invasive). The Ravitch procedure involves removing deformed cartilage and repositioning the sternum, while the Nuss procedure uses a curved titanium bar to reshape the chest with smaller incisions and faster recovery times.

The Bristol - Myers Squibb Children's Hospital at RWJ University Hospital

This hospital in New Brunswick, NJ (close to the New York area) is nationally ranked in 2 pediatric specialties. It has a competent pediatric surgical team that can provide treatment for children with pectus excavatum. The hospital focuses on providing evidence - based care and offers advanced surgical techniques to ensure the best possible outcomes for the children.

Lerner Children’s Pavilion - Hospital for Special Surgery

Lerner Children’s Pavilion - Hospital for Special Surgery in New York is nationally ranked in 1 pediatric specialty. It has a specialization in orthopedic and related surgical procedures, which can be beneficial for children with pectus excavatum. The hospital's expertise in skeletal and musculoskeletal care can complement the treatment of chest wall deformities, ensuring a comprehensive approach to the child's condition.

Factors to Consider When Choosing a Hospital for Pectus Excavatum Treatment

Expertise of the Medical Team

The experience and expertise of the pediatric surgeons are crucial. Surgeons with a long - standing experience in treating pectus excavatum are more likely to perform the procedures successfully and handle any complications that may arise. They should be well - versed in the latest surgical techniques, such as the Nuss procedure and the Ravitch procedure.

Treatment Options

A good hospital should offer a variety of treatment options, including both surgical and non - surgical methods. Non - surgical options like vacuum bell therapy may be suitable for some children, while surgical options should be tailored to the severity of the condition. The hospital should also be able to provide comprehensive pre - operative and post - operative care.

Facilities and Technology

State - of - the - art facilities and advanced medical technology are essential for accurate diagnosis and successful treatment. This includes high - quality imaging equipment for diagnosing the severity of pectus excavatum and advanced surgical tools for performing the procedures.

Patient Support Services

Going through treatment for pectus excavatum can be stressful for both the child and the family. A hospital that offers patient support services such as counseling, support groups, and educational resources can greatly help in managing the emotional and practical aspects of the treatment process.

Reputation and Rankings

Rankings from organizations like US News and World Report can give an indication of the hospital's overall quality and performance in pediatric care. A hospital with a good reputation in treating pectus excavatum is more likely to provide high - quality care.

Comparison of Treatment Methods

Surgical Methods

Non - Surgical Methods

Non - surgical treatment often involves the use of a vacuum bell, which is a device that applies negative pressure to the chest to pull the sternum outward. When paired with exercises and stretches, it can lead to some improvement in the condition. For example, at Nationwide Children's Hospital, patients who choose non - surgical treatment have seen excellent results, with approximately 80 percent seeing an elevation greater than 1 cm within 3 months, approximately 20 percent seeing complete correction within 6 months, and approximately 13.5 percent seeing complete correction within 18 months.

Case Studies

Case 1: A 13 - year - old boy at New York - Presbyterian Morgan Stanley Children's Hospital

A 13 - year - old boy was diagnosed with moderate pectus excavatum. He had been experiencing shortness of breath during physical activities and was self - conscious about his appearance. At New York - Presbyterian Morgan Stanley Children's Hospital, the pediatric surgical team decided to perform a Nuss procedure. The minimally invasive nature of the surgery allowed for a quick recovery. After two days in the hospital, the boy was able to go home. Over the next few months, his breathing improved significantly, and his self - confidence also increased. After three years, the bar was removed in an outpatient procedure, and he continued to have a normal and active life.

Case 2: A 15 - year - old boy at Johns Hopkins Children's Center

A 15 - year - old boy with severe pectus excavatum was referred to Johns Hopkins Children's Center. The medical team evaluated his condition using the Haller index and other diagnostic tests. They decided to perform a modified Nuss procedure. The modifications made by the center's experts allowed for improved safety during the procedure. After the surgery, the boy's chest shape improved significantly, and his heart and lung functions also showed signs of improvement. He followed up regularly with the medical team, and with proper post - operative care, he was able to return to his normal activities within a few weeks.

Conclusion

Treating pectus excavatum in children requires a combination of medical expertise, advanced technology, and a patient - centered approach. The top ten hospitals in New York City for treating this condition offer a wide range of services and treatment options. Whether it's through surgical methods like the Nuss or Ravitch procedures or non - surgical approaches, these hospitals strive to provide the best possible care for children. When choosing a hospital, parents should consider factors such as the expertise of the medical team, available treatment options, facilities, patient support services, and the hospital's reputation.

If your child is suffering from pectus excavatum, don't hesitate to reach out to these hospitals. Contact them for more information, schedule an appointment, and take the first step towards your child's better health and well - being. You can call the hospitals directly or visit their official websites to learn more about their services and treatment procedures.