Age-related normal ranges for the Haller index in children

The Haller index is an accepted CT method for evaluating thoracic dimensions in patients with pectus excavatum. The purpose of this study is to establish age- and gender-related norms for the Haller index in childhood.

We retrospectively reviewed 574 consecutive chest CT examinations (M=285, F=289) performed at our institution from August 2001 through March 2002. Seventeen patients with a history of chest-wall deformity, trauma, or syndrome were excluded, for a total sample size of 557 patients. The Haller index was calculated for each patient, using electronic calipers. The sample population was then separated by gender and placed into 2-year age groupings. Two-way analysis of variance and Tukey's multiple comparisons were performed to determine significance at a=0.05. The least-square mean Haller index values for each age group and gender were calculated with 95% confidence intervals.

In both males and females, the 0- to 2-year age group showed a significantly smaller mean Haller index than older children. In addition, females had significantly greater Haller index values than males in the 0- to 6- and 12- to 18-year age groups.

The Haller index, a quantitative measurement of chest-wall configuration, demonstrates significant age- and gender-related variability. This should be considered when evaluating the patient with suspected chest-wall deformity.