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What Is the Most Common Misconception about Chest Wall Conditions?
What are the symptoms? How common are they? What is the treatment process? In this short video, Program Director Dr. Lisa Smith answers these questions and more.
Chest Wall Reconstruction Program
Erlanger Medical Mall
979 East 3rd Street, Suite 300
Chattanooga, TN 37403
Fax for Referrals: 423-778-5177
Comprehensive, Patient-Centered Care for Chest Wall Deformities
Children’s Hospital at Erlanger is home to the region’s only pediatric Chest Wall Reconstruction Program. Using a patient-centered, multidisciplinary approach, our program empowers children and adolescents to attain optimal functionality and enhanced aesthetic results. We offer the latest minimally invasive reconstruction procedures to treat deformities such as pectus excavatum, pectus carinatum, pectus arcuatum, and other complex chest wall anomalies.
What Are Chest Wall Disorders?
Chest Wall Deformities are structural developmental abnormalities of the chest wall. These conditions can significantly impact both physical appearance and physiological function, reducing cardiopulmonary (heart and lung) function, affecting posture and overall quality of life.
Pectus Excavatum
A sunken or caved-in appearance of the chest, which can compress the heart and lungs, often leading to reduced cardiac and pulmonary function.
Pectus Carinatum
An outward protrusion of the chest wall, often called "pigeon chest," which causes restriction of chest wall motion, discomfort, and self-consciousness.
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Pectus Arcuatum
A rare curving or arching of the chest wall, causing an S-shaped sternum. It has characteristics of both excavatum and carinatum.
Our Approach to Care
What to expect during the initial evaluation...
- An in-depth consultation and a detailed medical history
- A complete physical examination
- Time to discuss and ensure clear understanding of the findings
As needed, the initial evaluation process may include:
- Further tests like imaging or pulmonary function assessments to better understand each patient's chest wall condition
- Connecting patients with other pediatric specialists, including cardiologists, pulmonologists, or geneticists, to evaluate for associated conditions.
If surgery is recommended...
Here are typical steps in the surgical journey:
- Preoperative Education: The surgical journey begins with informative sessions to prepare patients and families for treatment.
- Prehabilitation ("Pre-hab"): We teach each patient exercises and breathing techniques to strengthen the chest wall before surgery.
- Surgical Intervention: This may include minimally invasive procedures, such as the Nuss Procedure for Pectus Excavatum and the highly modified Ravitch procedure for Pectus Carinatum and Arcuatum.
- Postoperative Care: After surgery, we provide ongoing support, including pain management and physical therapy, to ensure a smooth recovery.
If a non-surgical approach is recommended...
- For many patients with Pectus Carinatum, non-operative bracing is an effective treatment. About 85% of these patients achieve significant improvement with custom-fitted braces, avoiding the need for surgery. Our bracing program is tailored for children and adolescents, ensuring optimal outcomes.
- For patients with mild Pectus Excavatum, a nonoperative approach can be highly effective. This includes targeted physical therapy to strengthen the chest wall and improve respiratory mechanics. The goal is to correct secondary musculoskeletal changes—such as rounded shoulders and scapular winging—to improve function and appearance.
Benefits of Treatment
Correcting chest wall deformities can lead to:
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Improved posture and chest wall motion
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Enhanced cardiac and pulmonary function
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Increased exercise tolerance and stamina
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Boosted self-confidence and quality of life
Meet Our Medical Director
Dr. Lisa A. Smith is Medical Director for the Pediatric Chest Wall Program at Children's Hospital at Erlanger. A fellowship-trained pediatric surgeon with over two decades of experience, Dr. Smith is a leader in chest wall reconstruction. She has evaluated thousands of patients and performed more than 400 chest wall reconstruction surgeries.