Two-staged Correction for Pouter Pigeon Chest: A Less Invasive Procedure

Surgical correction of pouter pigeon chest deformity traditionally requires invasive procedures including total removal of the affected costal cartilages and major dissection of the sternum. We present a novel minimally invasive two-stage technique that was applied to an 8-year-old girl. First, the depressed lower chest was elevated using a plate with the Nuss procedure. Then, after 30 months, simultaneously with plate removal, correction of the remaining projection of the upper chest was also performed. This involved excision of only two pairs of deformed costal cartilage and a local osteotomy at the manubriosternal joint. Intraoperative blood loss was 20 mL, and the patient was discharged 7 days postoperatively. Because both the primary and secondary stages involve manual bending of the costal cartilages, our procedure may be suitably indicated only for patients in their early teenage years.