Chest malformations (keel chest, funnel chest)

While some patients show no symptoms, others report shortness of breath on exertion, reduced performance during sport or social withdrawal. Those affected often avoid places such as public showers or bathing establishments.

While thoracic malformations are sometimes already visible in infancy, the full extent of the malformation typically becomes apparent during the growth spurt in puberty.

The treatment depends on various factors: the extent of the malformation, the severity of the symptoms, the individual's desire for treatment and the willingness to participate in therapy.

Depending on the situation, the following options may be possible:

• Physiotherapy with targeted stretching and muscle-building exercises
• Suction cup therapy for funnel chest
• Orthosis for keel chest (several hours a day for months to years)
• Surgical correction for more pronounced forms

The UKBB is one of the few centres that offer both conservative and surgical procedures for funnel chest and keel chest. The procedures are usually minimally invasive (keyhole technique), resulting in barely visible scars later on. The paediatric surgery team at the UKBB is internationally networked and works according to the latest standards.

Only the surgical treatment of thoracic malformations requires hospitalisation, which usually lasts around five days.

The prognosis, even for the most severe malformations, is generally excellent following surgical treatment. Immediately after the operation, the contour of the chest is completely normalised and patients are very satisfied with the result in most cases. Survey studies conducted at UKBB confirm this positive development and show that almost all patients who have undergone surgery would opt for surgery again.

The prognosis after suction cup therapy for funnel chest varies depending on the individual case. If this therapy does not bring the desired success, there is always the option of surgical treatment.

• Failed Preoperative Vacuum Bell Therapy does not affect outcomes following Minimally Invasive Repair of Pectus Excavatum. Pediatric Surgery International 07/2021. Muff J, Guglielmetti LC, Gros S, Buchmüller L, Frongia G, Holland-Cunz SG, De Trey T, Vuille-dit-Bille RN
• Minimally Invasive Repair of Pectus Excavatum (=MIRPE) according to Nuss. Paediatrica Vol 33;1-2022. de Trey T,Vuille-dit-Bille RN, Holland-Cunz SG