Pectus Carinatum (Pigeon Chest) Treatment

Pectus Carinatum (Pigeon Chest) Treatment

Pectus Carinatum, commonly known as pigeon chest, is the second most frequently seen chest wall abnormality after pectus excavatum (funnel chest). It occurs when the cartilage connecting the ribs to the sternum grows abnormally. The sternum is commonly referred to as the breastbone.

The condition appears as a noticeable protrusion on the chest wall. It generally develops in the costal cartilages attached to the breastbone. In some patients it occurs bilaterally, while in others it is seen only on one side.

The abnormal cartilage growth responsible for pigeon chest typically emerges during adolescence, generally between the ages of 11 and 15. This condition is more commonly observed in males.

What Are the Symptoms of Pigeon Chest?

• The individual may experience chest pain or shortness of breath related to physical activity.
• Lying face down may cause chest pain or tenderness in the chest area.
• Surprisingly, 1 in every 4 individuals may present with asthma-like symptoms.
• Due to the altered chest appearance, patients may experience negative psychological effects.
• Respiratory complaints may occur.
• Although there are no clearly defined symptoms specific to this condition, extensive research is still ongoing.

What Are the Types of Pectus Carinatum?

Pectus carinatum is a relatively common condition characterized by an abnormal outward protrusion of the sternum. Its severity can range from mild to advanced. In mild cases, the protrusion may be barely noticeable, while in advanced cases it can be pronounced enough to affect breathing and heart function.

There are two main types of pectus carinatum:

• Chondrogladiolar Pectus Carinatum: The most common type. It results from abnormal growth of the cartilage connecting the ribs to the sternum.
• Chondromanubrial Pectus Carinatum: A less common type. It results from abnormal growth of the cartilage connecting the sternum to the ribs.

In some cases, pectus carinatum may also result from a combination of genetic and environmental factors.

How Is Pectus Carinatum Diagnosed?

Pectus carinatum can primarily be diagnosed through a physical examination. The doctor evaluates the chest to assess the characteristic outward protrusion of the sternum. Additional tests such as a chest X-ray or computed tomography (CT) scan may be requested to rule out other conditions.

Some of the tests that may be used during the diagnostic process include:

• Chest X-ray: A simple and painless test that can show the shape of the chest and the size of the sternal protrusion.
• Computed Tomography (CT): A more detailed imaging method that provides more comprehensive information about the chest structure.
• Echocardiography: This test, which uses sound waves to visualize the heart, can be used to evaluate potential cardiac issues associated with pectus carinatum.

If symptoms are noticed, consulting a doctor is important for accurate diagnosis and determination of appropriate treatment options.

What Are the Treatment Methods for Pigeon Chest?

Pigeon chest is not a commonly seen condition. However, since it becomes apparent during early adolescence, it is a treatable condition. Treatment is determined based on the severity of the condition and the patient's individual status. This treatment is carried out in two ways: surgical treatment and brace treatment.

Surgical Treatment: In this treatment, the patient undergoes a modified Ravitch procedure. For this operation, an incision is made in the affected chest area. The abnormally grown cartilage is removed, and the chest area is pushed back into position. In some cases, if deemed necessary by the doctor, a metal bar may be temporarily placed over the chest.

Following this operation, which involves significant and intense pain, the length of hospital stay is planned according to the patient's condition. This duration may also vary depending on the level of pain experienced by the patient.

Another surgical method is the Abramson Procedure. During this operation, large incisions are not made in the chest; instead, the procedure is performed through small incisions. Depending on the patient's condition, this operation takes approximately 30–45 minutes and is performed under general anesthesia.

The hospital stay following this procedure is typically 4–5 days, although this may vary depending on the patient's condition. Sudden movements should be avoided. With the doctor's approval, the patient can return to normal life after 2–3 weeks. If the patient is a child, they may return to school after 2–3 weeks, again with the doctor's approval.

Brace Treatment: Another preferred method is brace treatment. The brace worn by the patient applies pressure to the ribs from behind and to the breastbone from the front, aiming to bring the chest back into its normal position.

The patient must wear the brace for 18–20 hours a day over a period of 2 years. As recommended by doctors, it should only be removed while showering and exercising. Unless otherwise instructed, the doctor's guidance should be followed precisely.

How Does the Post-Operative Recovery Process Proceed?

Recovery time may vary from person to person depending on various factors. The general process that can be expected is as follows:

• The First Days After Surgery: Immediately after the operation, the patient remains in the hospital for a few days for observation and pain management. Pain, swelling, and discomfort may be experienced during this period.
• The First Weeks: In the weeks following surgery, mobility is gradually regained and pain begins to subside. The surgeon guides the patient regarding wound care and pain management.
• The First Month: By the end of the first month, the patient may return to low-intensity activities such as walking and light stretching exercises. The surgeon's recommendations should be carefully followed to prevent complications.
• 3–6 Months: Within three to six months after surgery, most individuals can return to moderate physical activities. Following a rehabilitation plan determined by the surgeon or physiotherapist supports the recovery process.
• 6–12 Months: Full recovery generally occurs within six to twelve months after surgery. During this period, strength and flexibility are regained in the chest area, and surgical scars gradually become less noticeable.

Does Pigeon Chest Grow Over Time?

Pigeon chest disease, while congenital, often becomes apparent at a young age. As this condition is generally seen in children, and since bone development and growth are not yet complete, it tends to progress as the child grows.

Surgery can be performed at 1–2 years of age, but this is not recommended. Operations are generally performed during adolescence or at an earlier stage, such as around 7–8 years of age.

Does Pigeon Chest Resolve on Its Own, and Does It Worsen with Age?

Pectus carinatum is a congenital condition that is typically noticed during childhood and adolescence. During this period, in some cases, the chest wall may naturally reshape itself as the body grows and develops, and the prominence of the protrusion may decrease. However, this spontaneous improvement is not an expected outcome in every patient, and the severity of the condition can vary from person to person.

In general, pectus carinatum typically does not worsen with age; in some patients, the protrusion may remain stable throughout adulthood without causing significant health issues. However, in other patients—particularly when left untreated—the deformity may become more pronounced over time.

If the chest protrusion causes physical discomfort or psychological distress, it is recommended to consult a doctor. Since the chest wall is more flexible during childhood, early evaluation and intervention are generally known to produce more effective results.

Exercise for Pigeon Chest

If pigeon chest is at an early, non-advanced stage, it can potentially improve through sports and physical activity. However, if the appearance and symptoms are more advanced, a surgical intervention may be required under a doctor's supervision.

Following surgery, patients are advised to stay in close communication with their doctor and refrain from engaging in any sport or activity contrary to the doctor's recommendations.

Brace Treatment for Pigeon Chest

Although surgery may be necessary for individuals with pigeon chest, in some cases the doctor may instead recommend brace treatment. This is particularly common in children whose bone development is not yet complete, provided the deformity is not at an advanced stage; treatment is initiated using a brace known as an orthosis.

In children, the purpose of using this brace is to treat the condition by allowing the still-flexible, undeveloped bone structure to reshape more easily.

The orthosis is a device that helps the chest regain its normal shape by applying pressure to the ribs from behind and to the sternum area from the front. Under a doctor's supervision, this device is retightened every 4-6 weeks to continue the process of reshaping the chest.

What Causes Pigeon Chest?

The exact cause of pectus carinatum is not fully understood, although it is believed that multiple factors play a role in its development.

One of the primary causes of pigeon chest is the abnormal growth of the cartilage tissue connecting the ribs to the sternum. This abnormal growth can push the sternum outward, causing the chest to take on a protruding shape. Genetic factors may also play a role in the development of pectus carinatum, as the condition tends to run in families.

Other factors that may contribute to the condition include certain medical conditions such as Marfan syndrome, scoliosis, and rickets. Additionally, poor posture during childhood and adolescence, such as slouching or a forward-leaning stance, can place pressure on the chest and contribute to the development of pigeon chest.

While pigeon chest generally does not cause serious harm to health and is not painful, it can lead to self-esteem issues and, in advanced cases, may affect lung and heart function.

In conclusion, although the exact cause of pigeon chest is not fully known, it is considered that a combination of genetic and environmental factors, along with abnormal cartilage growth, contributes to this condition.

What Are the Possible Complications of Pectus Carinatum?

In most cases, pectus carinatum does not lead to serious complications. However, in some cases, the following issues may arise:

• Shortness of Breath: The protrusion in the sternum can place pressure on the lungs, making breathing difficult.
• Chest Pain: The protrusion in the sternum can also place pressure on the heart, causing chest pain.
• Self-Esteem Issues: Pectus carinatum can lead to self-esteem issues due to the individual feeling uncomfortable about their appearance.
• Heart Problems: In rare cases, pectus carinatum may be associated with heart problems such as arrhythmia and heart failure.

Harmful Effects of Pigeon Chest

In general, if there are no distressing symptoms, pigeon chest does not pose a serious threat to health. However, since it is particularly seen in children during adolescence, it can seriously affect children of that age, leading to psychological issues. For this reason, they often wish to seek treatment.

When this condition is treated under the supervision of a thoracic surgery specialist at an early age, before bone development is complete, more favorable results can be achieved.

Is It Possible to Prevent Pectus Carinatum?

Pectus carinatum is generally a congenital condition that arises from the shaping of the chest wall during fetal development. For this reason, since the condition is largely determined by genetic factors and elements beyond our control, there is no definitive method for preventing it.

Research shows that genetic factors play a significant role in the development of pectus carinatum. Individuals with a family history of chest wall deformities may have a higher likelihood of developing this condition. Since genetic predisposition cannot be altered, the options for prevention remain limited.

At this point, the most effective approach is early recognition of the condition and initiating an appropriate monitoring and assessment process.

What Does Life Look Like After Surgery?

Psychological and Emotional Adjustment: The process following pectus carinatum surgery is not limited to physical recovery alone; it also encompasses psychological and emotional adjustment. Many individuals report improvements in self-esteem and body image perception after surgery. However, it should be kept in mind that this emotional process may progress differently for each person. Some patients may wish to benefit from counseling and support groups for persistent emotional concerns or body image issues.

Physical Activity and Lifestyle: Surgery can significantly affect a person's physical capacity and overall lifestyle. Many individuals report being able to breathe more comfortably and participate in physical activities without the limitations imposed by the chest deformity. Regular exercise, particularly movements that strengthen the chest area, can help support post-surgical outcomes and overall health.

Follow-Up Care: Continuing with regular check-ups is important for monitoring the recovery process and detecting any potential issues early. The surgeon schedules follow-up appointments to assess healing, and patients with surgical scars may be guided on scar care.

Pigeon Chest Treatment in Turkey

Pectus carinatum, or pigeon chest, refers to the abnormal forward growth of the cartilage structure in the chest area, and treatment for this condition is available in Turkey.

Turkey has made significant technological advancements in the field of medicine, offering solutions to many conditions and becoming a beacon of hope for patients. Since conditions that seriously and negatively affect people's lives are treated in Turkey with high success rates, Turkey is among the countries frequently preferred by international patients.

The quality of hospitals and doctors, affordable prices, the vacation opportunities available in Turkey, and the friendly and warm approach of caregivers are among the many factors that further strengthen these preferences.

The price of pigeon chest treatment performed in Turkey varies depending on the condition of the disease and the type of treatment to be applied. For more precise and detailed pricing information on this matter, please feel free to contact us.