How to treat funnel chest

  Funnel chest is the most common congenital thoracic deformity, mostly found at birth, the incidence rate is about 0.1%, this congenital deformity is manifested at birth as the sternum as the center of the front chest wall depression, shaped like a funnel, and increasingly aggravated with growth and development, the development of thoracic deformity accelerates during youth development, rarely can be self-healing or self-healing through exercise. Due to the compression of the heart and lungs by the sunken sternum, the development of organs will be hindered, and the symptoms will be aggravated gradually by respiratory infections and decreased activity endurance. It causes great mental burden and psychological stress to the affected children and their parents. Some patients may become introverted, inferior, or even depressed, especially after entering adolescence.  The etiology of funnel chest is still unknown, but it may be due to the excessive unbalanced growth of rib cartilage. The incidence of funnel chest is 6 times higher than that of chicken chest. Funnel chest is not related to calcium deficiency and calcium supplementation cannot treat funnel chest.  Treatment: Surgical correction is the only option to improve the condition. Mild deformities without symptoms are followed up regularly. The disease has a tendency to worsen with growth, especially during the growth spurt, and can change from mild to severe within 6-12 months. Clinical symptoms, severe deformity, or worsening of symptoms during follow-up; chest CT showing: heart and lung compression, CT index R3.25 (CT index is not suitable for funnel chest with predominantly flattened chest); recurrent funnel chest, etc. all require surgery. According to foreign literature about 20% of patients are operated due to psychological factors. The surgical methods used in the past include sternal reversal, resection or cutting of rib cartilage, which are rarely used due to the great damage, long operation time, poor surgical results, high recurrence rate after surgery, especially the compliance of the chest wall (that is, the elasticity of the chest wall) is significantly reduced. At present, the main popular surgical methods are minimally invasive funnel chest correction and ultra-minimally invasive funnel chest correction, which has been improved to address its shortcomings.  Minimally invasive funnel chest correction: In 1988, Donald Nuss, an American doctor, in cooperation with WaiterLorenzSurgicalInc. established a new minimally invasive procedure to correct funnel chest (called NUSS surgery). Its advantages are: 1. Small trauma: the incision is only 3-4 cm, with little intraoperative bleeding; 2. Easy surgery: a steel plate can be used to lift the depressed chest wall; 3.  4, the compliance of the chest wall is not lost, etc.; the chest wall maintains its original elasticity, which is very important for the improvement of lung function.  However, NUSS surgery is not perfect, and there are still many areas that need to be improved. Therefore, based on NUSS surgery, ultra-minimally invasive funnel chest correction has been developed. This surgery not only retains the original advantages of NUSS surgery but also overcomes its main disadvantages: 1, less traumatic: the incision is only 1.5-2.5 cm, less bleeding, no violent turning of the plate in the body, and even no drops of blood can be seen during the whole surgery.  2.Simpler surgery: the surgery process is simplified from the original 3 processes to one step, and the surgery time can be shortened by 1/2-1/3, and the tedious process of processing the steel plate during the surgery is also eliminated.  3.Better surgical effect: the design of the steel plate is more reasonable, the stability is better, the surgical effect can be maintained from the beginning to the end, and the steel plate will not restrict the growth and development of children, and the post-operative thoracic shape is more perfect.  4.Less pain for the patient: due to the small trauma and good stability of the steel plate, the pain is lighter and shorter for the patient after the surgery, and the patient can sleep on his side after the surgery instead of sleeping flat for six months like NUSS.