A Review of Current Treatment Trends in Pediatric Chest Wall Abnormalities

Pediatric chest wall abnormalities are defined as any structural abnormality affecting the sternum, ribs, musculature, or thoracic spine, which alters the normal structure or limits the function of the thorax [1]. Of these deformities, pectus excavatum and carinatum are the most common sporadic malformations with both physiologic and psychological implications in patients affected. In some cases, pectus malformations can be associated with genetic syndromes and familial inheritance with the syndromic manifestations exhibiting cardiac and renal anomalies in association with the chest wall deformity [2]. Jeune’s Asphyxiating Thoracodystrophy Syndrome, cleft sternum, and musculoskeletal deformities after repair of large congenital diaphragmatic hernia are other chest wall abnormalities that can be more severe in their course and difficult to manage. These can be life threatening due to the inability of the thoracic cage to expand, result in exposure of the heart, or are associated with other cardiac malformations [3]. Poland Syndrome is a malformation of the ribs and chest wall musculature, associated with hypoplasia or aplasia of the breast or nipple and ipsilateral limb abnormalities, with correction and repair being more of a cosmetic issue than a functional problem, as there is no underlying pulmonary deficit [3,4].