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Sunken Chest Demands Prompt Evaluation, Expert Says
Date:11/17/2011

THURDSAY, Nov. 17 (HealthDay News) -- Children with sunken chest require prompt evaluation to rule out more serious underlying conditions and to plan corrective surgery if necessary, according to experts.

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 and is rarely life-threatening.

The main reason to perform surgery is to improve heart and lung function, not to improve appearance, Dr. Fizan Abdullah, a pediatric surgeon at Johns Hopkins Children's Center in Baltimore, explained in a Hopkins news release.

He said assessment of children with sunken chest accomplishes three goals: rules out serious underlying syndromes; assesses cardio-pulmonary function; and begins the planning of surgery.

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, Abdullah said.

A sunken chest can compress the heart and lungs and affect breathing and circulation, especially in more severe cases. Serious heart and lung problems are rare, but even children with mild sunken chest can have reduced cardiovascular endurance, tire quickly, have a feeling of pressure on their chest, and experience neck and back pain.

Surgery can remedy these problems and restore the chest to normal appearance. Several different surgical approaches can be used, including minimally invasive alternatives to open-chest surgery, Abdullah said.

The ideal time for surgery is between ages 14 and 16, Abdullah said. Doing the surgery at an earlier age when a child's bones are still growing could result in reemergence of the sunken chest. However, earlier surgery would be performed in severe cases that seriously compromise heart and lung function, Abdullah said.

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