Chest Wall Deformity, Sydney

Pectus Excavatum

Pectus Excavatum, commonly known as funnel chest, is a condition where the central bone of the chest is sunken. The sunken appearance of the breastbone is commonly seen in young children and usually becomes more pronounced during adolescence when there is rapid growth.

In this condition, the cause of the unusual bone and cartilage growth is not unknown. In most cases there is no significant effect on heart or lung function. Children and teenagers come to the attention of a paediatric surgeon due to concerns about the appearance of the chest.

The deformity can be surgically corrected, and curved metal bars are placed behind the breastbone to push it forward. The bars stay in place for approximately two years at which point they are removed. This operation is performed under general anaesthetic. Thoracoscopy and sternal elevation are always used when placing a bar to ensure it is performed as safely as possible.

The patient usually stays in hospital for 4-6 days. There are restrictions on the patient’s activities for the first 3 months after surgery.

Dr Carolyn Russell has extensive experience in chest wall reconstruction and regularly performs these operations at Sydney Children’s Hospital (SCH) in Randwick. Dr Bruce Currie, a leading Australian paediatric chest wall and thoracic surgeon, together with Dr Russell currently consult at their multidisciplinary “Chest Clinic” at SCH, Randwick. They are very proud to be involved in a clinic that delivers exceptional assessment and care to their patients with chest wall deformities.

They also perform physiological testing of patients who wish to participate in their research projects.

Pectus Carinatum

Pectus Carinatum, commonly known as pigeon chest, is a condition where the central bone of the chest protrudes. This appearance is most commonly noticed in later childhood and becomes more prominent during adolescence. Similar to pectus excavatum, the underlying cause of the abnormal growth of bone and cartilage is unknown.

The condition causes no impact on cardiac or respiratory function. Commonly, the child or parents have concerns about the appearance of the child’s chest and seek an opinion. These days, most patients with pectus carinatum are suitable for chest wall bracing and are referred to the SCH orthotist for fitting of a personalised brace.

The brace needs to be worn for long periods of time initially to achieve correction of the protrusion. The use of the brace is then weaned over several months. Some patients do not tolerate wearing the brace and may request surgical correction of their pectus carinatum.

Complex Chest Wall Deformities

Sometimes children develop complex chest wall deformities following surgery for correction of conditions they were born with, such as trachea-oesophageal atresia or a congenital diaphragmatic hernia. In other circumstances, a chest wall deformity may develop following resection of a tumour. All of these conditions can be assessed and managed at Dr Russell and Dr Currie’s multidisciplinary ‘Chest Clinic’ at Sydney Children’s Hospital in Randwick.

Dr Carolyn Russell would be delighted to meet with you regarding your child’s chest wall deformity. All necessary investigations will be arranged at your appointment at the ‘Chest Clinic’.

Please ask your GP to refer you to the ‘Surgical Chest Clinic’ at the Outpatients Department of Sydney Children’s Hospital in Randwick. They can be contacted via SCH on 02-9382 1111, and follow the prompts to the Outpatient Clinic.

For any other issues please call 02-9540 4409 to speak with our helpful reception staff, or complete our online contact form.