Recently there has been a statement on the internet that people with funnel chest do not live to be 40 years old. What kind of disease is a funnel chest, how does it affect one’s life, and to what extent. In this regard, we will introduce the causes, effects, development of correction techniques and other related knowledge of funnel chest. What is a funnel chest? The disease funnel chest is a congenital disease, the incidence of which is still relatively high in the population, generally in the range of 1 in 1,000 to 4 in 1,000. Of course, the degree of funnel chest can be mild or severe, and some patients, as we know, have a family history. In patients with a family history, we have researched and found that the genes for funnel chest are on the chromosomes and can be passed on to the next generation. In terms of genetic terminology, some of them are recessive and may be passed from generation to generation, not every generation develops the disease. There is also a part that is dominantly inherited, which is possible for all offspring. There is also one that is inherited with the sex chromosomes. Funnel chest is a congenital deformity of the chest wall, and it is difficult to correct through acquired factors. For example, some patients try to take more calcium in the hope of correcting it, but it doesn’t really make much sense. The danger of funnel chest is often infantile, and the lighter family members are often unaware of it and feel it is relatively mild and ignored. There are also relatives who can still pay attention to the information about funnel chest and can be seen in time, then it can be corrected in time during childhood. The neglected child only notices it when the child is a little older, or even in some cases until the adult, and then the symptoms become more and more obvious. The harm caused is mainly twofold: one is the compression of the heart and lungs, causing physiological damage. The human thorax is mainly 12 pairs of ribs, thoracic vertebrae, clavicle, rib cartilage, sternum, constituting a barrel-shaped structure, the upper head is small, the lower head is large. The ribs and sternum are connected by rib cartilage. The changes in funnel chest are mainly the deformation of the chest wall in which the sternum and rib cartilage are recessed inward, which produces compression of the heart and lungs, and in some patients even produces deformation of the heart and has an effect on the function of the ventricles. For compression of the lungs, the symptoms may not be obvious in the short term. However, with increasing age and exercise, the symptoms become more pronounced. For example, they are easily fatigued during activities, easily shortness of breath, panic attacks, faster breathing rate than others, and even inability to do heavier physical work and sports. The second is the psychological impact. Initially, the child does not have a big heart stress without noticing it. However, once the child learns that his or her chest wall is different from others and that it is a disease or deformity, a shadow often looms over the child’s mind. The child is prone to personality changes, such as introversion and reluctance to communicate with others, which in psychological terms is called a psychological disorder, also called social phobia. There is also a child who is reluctant to make contact with others, even at a very old age, and is still reluctant to talk to friends for fear of others finding out about his physical abnormalities. Other children in more severe cases can develop depression, or even schizophrenia, among other disorders. Many parents ignore the psychological changes in their children, knowing only that the child’s personality has changed, but not noticing the reasons for the changes. Parents should find the cause as soon as possible, and if it is indeed caused by a funnel chest, then it should be treated promptly with good results. Funnel chest is not necessarily the main cause of life expectancy It is difficult to answer in one sentence whether funnel chest has an effect on life expectancy. Because funnel chest is a congenital disease, often in combination with some other congenital diseases, such as Marfan’s syndrome, a heart malformation combined with thoracic deformity, other manifestations are very tall, long limbs, long fingers, commonly known as “spider fingers”, that is, fingers like spider legs, very graphic. There is another condition, such as multiple neurofibromatosis, which is characterized by thoracic depression, neuronal tumors, and multiple coffee-colored spots on the skin, as well as limb deformities, such as short fingers, diseased fingers, and queer metacarpals. There is also a funnel chest combined with spinal deformities, such as scoliosis, scoliosis, retroflexion, and retroconvexity of the spine. Statistically, the prevalence is about 30%. In severe cases, the spine is almost at right angles. The spine itself is an important organ for the spinal cord to travel through, and if the spine becomes right-angled, it can flatten the spinal cord and even change the cells inside. According to statistics, a significant portion of these patients will become paraplegic in adulthood, which will have an impact on their lives and life expectancy. There are also thoracic deformities that are very heavy and cause pressure on the heart. The heart is generally about the size of my fist and has four chambers, the left and right atria and the left and right ventricles. Between the atria and the ventricles there are valves. Because of the compression, the valve ring of the valve door causes distortion, and the valve door “does not close tightly”. The most common type of valve prolapse is caused by a funnel chest, with about 30% of foreign statistics. To summarize: first, funnel chest can be combined with congenital diseases, including heart and other organ diseases. Second, the compression of organs by the funnel chest causes structural changes in the organs. All of these conditions can be harmful to the patient’s life and quality of life. Minimally invasive surgery: a boon for patients with funnel chest The treatment of funnel chest with minimally invasive techniques for correction has been available only in recent years in China and only about 10 years abroad. In fact, the treatment of funnel chest has a long history, but there has never been an ideal solution. Minimally invasive has very obvious advantages over traditional methods. One of the traditional corrective surgeries for funnel chest is the reversal method. By cutting off the sternum and the deformed rib cartilage, and then turning it over, it is corrected. The biggest problem of this surgery, because the rib cartilage and sternum are cut off, it is difficult to not be misaligned at all during the healing process, and once misaligned, there will be a local deformity. This method was used in the 70s and early 80s. It was done most often in preschool children, and adults were generally not satisfied with the results of this surgery, which affected not only the confidence of the patient but also that of the doctor. After the 90s, another method was used to treat funnel chest, which is to remove the deformed rib cartilage, sew it up again, so that the sternum does not flip over, and then hold it up with a support bar. It is much simpler than the first one, relatively better in terms of time and trauma, and relatively better in terms of deformity correction. However, we still have defects in the long run. There is still a relatively long incision, which poses aesthetic problems, and the deformity correction is not very good. The first two are more invasive orthopedic procedures. Nowadays, minimally invasive surgery is a different world. Initially aimed at children, the advantage is that the incision is relatively small, but also allows for real image surveillance in real time to perform the maneuver. This maneuver requires passing the mediastinum from the back of the sternum, one side to the other, then putting the support bar in, flipping it over, and lifting the sunken thorax. Because of the assistance of thoracoscopy, the safety is significantly improved. After a longer period of observation abroad, there is a more satisfactory treatment effect for children. It is doubtful whether this technique can be applied to adults. Some attempts have been made in recent years. Most foreign countries started to try it after 98 years, and most Asian countries started to try it after 2000 years. We are also an early attempt to start minimally invasive orthodontics for adults. In recent years, we have done hundreds of surgeries, and the results are still very satisfactory from the recent three to four years of observation. Minimally invasive is characterized by small trauma, quick recovery after surgery, early bedtime activities, and low risk. Compared to conventional, minimally invasive surgery has no intraoperative death and no serious complications. In terms of orthopedic surgery, it is indeed a conceptual change and a great boon to patients with funnel chest. Especially for adult patients with funnel chest, it is a misconception that most hospitals and doctors believe it is incurable and do not recognize the danger to life. This requires advanced knowledge to be disseminated. This knowledge needs to be available to the general public and to many doctors.