[The unsightly chest: Analysis and anomaly. Curative or palliative approach?]

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Plastic surgery

Background:

• Anterior chest wall deformities, primarily pectus excavatum and pectus carinatum, significantly affect patients' quality of life.
• While esthetic and psychosocial impacts are well-established, the cardiopulmonary functional impact remains debated.
• Various management strategies exist, including surgical and non-surgical interventions.

Purpose of the Study:

• To review the current understanding and management of anterior chest wall deformities.
• To discuss the spectrum of deformities and their respective treatment modalities.
• To highlight the importance of balancing surgical risks with patient outcomes.

Main Methods:

• Review of literature on anterior chest wall deformities.
• Discussion of surgical techniques (e.g., sternochondroplasty, Nuss procedure) and palliative/non-surgical options (e.g., silicone implants, vacuum bells, bracing).
• Consideration of rare deformities like sternal cleft and acquired restrictive thoracic dystrophy.

Main Results:

• Pectus excavatum and pectus carinatum are the most common deformities.
• Surgical options include open and minimally invasive techniques.
• Non-surgical approaches like vacuum assisted closure devices and bracing offer alternatives.
• Management decisions must weigh morbidity, mortality, and esthetic/functional goals.

Conclusions:

• The choice of management for anterior chest wall deformities requires a comprehensive evaluation of individual patient needs.
• Balancing the risks and benefits of surgical versus non-surgical interventions is crucial.
• Further research may clarify the cardiopulmonary functional impact of these deformities.