Sunken Chest Syndrome - Non-surgical Treatment
Synopsis: Using a vacuum bell to treat pectus excavatum a common congenital deformity of the chest wall caused by overgrowth of cartilage in the ribs and sternum.1
Author: Children's Hospital of The King's Daughters
Main DigestFirst patients in US receive non-surgical device of sunken chest syndrome. Surgeons at Children's Hospital of The King's Daughters (CHKD) have fitted a patient with a device that might eliminate the need for surgery in some patients with one of the world's most common chest deformities, pectus excavatum, often called sunken chest syndrome.
Sunken Chest Syndrome - Pectus excavatum is a congenital (present at birth) abnormality that can be mild or severe. It usually develops during pregnancy. Sunken or hollow chest, the result of a malformed rib cage, is one of the most common birth defects of the chest wall. It affects one in 300 to 400 children but is rarely life-threatening. A small number of children with sunken chest have Marfan Syndrome, a genetic disorder of the connective tissues that can cause potentially deadly problems such as arterial aneurysms or rupture of the heart's aorta. Pectus excavatum can be surgically repaired. Surgery is generally advised if you have other problems, such as trouble exercising.
Known as the vacuum bell, it works much like devices in body shops that use sustained vacuum to pop out a dent.
"Years from now, we may look at the surgeries and realize that many of these conditions could have been corrected with vacuum devices," said Dr. Robert J. Obermeyer, who is leading the project at CHKD, the nation's top research center for chest-wall deformities and a training site for surgeons from around the world.
Pectus excavatum is the most common congenital deformity of the chest wall. Caused by an overgrowth of cartilage in the ribs and sternum, its defining feature is a depression, or indentation, in the middle of the chest.
Until the 1980s, the only correction was a radical surgery that involved removing cartilage and ribs. In the late 1980s, Dr. Donald Nuss, a CHKD pediatric surgeon, developed a minimally invasive technique that involved placing a concave bar into the chest then flipping it over so that it pushes the depression of the chest upward. The Nuss Procedure has since become the surgical gold standard.
Today, CHKD performs more pectus excavatum surgeries than any facility in the United States and remains a major training site for surgeons and a center for research on chest wall deformities.
But even the minimally invasive surgery results in an average hospital stay of five days. Pectus specialists have been exploring less invasive techniques; research is being conducted in San Francisco on implanting magnets in the chest wall that are attracted to a chest brace.
The vacuum bell procedure marks the first use by pectus specialists of a non-surgical device. "CHKD has always made efforts to minimize surgical intervention and I believe this could eliminate the need for surgery in some pectus excavatum patients," said Dr. Obermeyer, who has been instrumental in bringing the technology to the U.S.
The vacuum bell device looks something like a large, silicone doughnut, with a bulb attached to remove air pressure. It must be fitted to each patient and fit snugly on the chest. The bulb is used to create a vacuum inside the device.
The vacuum bell must be used about an hour a day and slowly pulls up the depressed area of cartilage. After three to six months of use, the depression in the chest reaches close to the maximum correction. The patient must continue to use the vacuum bell for about two years to make the correction permanent, similar to wearing a retainer after one's teeth are straightened.
In Europe, the concept of a vacuum device to correct sunken chest syndrome has been discussed for decades, but technology lagged behind. German engineer Eckart Klobe, who suffered pectus excavatum, developed hundreds of prototypes before developing a device that worked reliably.
The vacuum bell has been used in Europe for several years, and research suggests that the correction might be permanent. Dr. Obermeyer visited pectus specialists in Switzerland who used the vacuum bell, met with Klobe, toured the production facility where the devices are manufactured and helped expedite its categorization by the Food and Drug Administration as a class 1 medical device, which allows for sale and use in the United States.
While the vacuum bell is non-surgical, it should be used under the supervision of a pectus excavatum specialist because underlying cardiac conditions can make the device dangerous, Dr. Obermeyer cautioned.
CHKD this week performed the first two procedures by pectus experts in the United States and will monitor their progress as well as the long-term effectiveness of the innovative non-surgical procedure.
Related Medical Research Documents
Full List of Medical Research Publications Full List of Disabled World News Updates
Recent Disability News and Updates
Full List of Disabled World News Updates
Disclaimer: Disabled World is strictly a news and information website provided for general informational purpose only and does not constitute medical advice. Materials presented are in no way meant to be a substitute for professional medical care by a qualified practitioner, nor should they be construed as such. Please report outdated or inaccurate information to us.
Disclosure: Disabled World is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Any 3rd party offering or advertising on disabled-world.com does not constitute endorsement by Disabled World. View our Advertising Policy for further information.