Intro
Pectus Excavatum, despite sounding like something from Harry Potter CHANGE SLIDE, is a condition that I, and statistically one other person in this room have. To quote Wikipedia, CHANGE SLIDE it is a congenital deformity of the anterior thoracic wall in which the sternum and rib cage grow abnormally. In other words, the chest looks like this CHANGE SLIDE. The opposite, rarer yet slightly more well known condition to this is Pectus Carinatum, or what is known as being pigeon-chested where the chest protrudes outwards, like this CHANGE SLIDE. Both types of chest deformities are relatively common, occurring in around 1 of every 400 people however with different severities. Another point to note is that 80% of the patients are male, with only 20% being female. The reason for this is unknown as of yet.
Causes
The majority of people with either chest conditions are born with them, however patients with illnesses such as spinal muscular atrophy can develop the conditions due to diaphragmatic breathing that is associated with the condition. The medical community as of the moment are not entirely sure what causes this defect, although it is expected to be genetic somewhat, as 37% of people with the condition have family members with it also. It has also been noticed that people with celiac disease are more prone to have this effect them for unknown reasons.
Effects
Depending on how severe the condition is, a number of repercussions may arise. Firstly, a number of patients have large heart defects due to compression of the heart CHANGE SLIDE. This, accompanied with the fact that it could also compress the lungs leads to a vastly reduced cardio-vascular system. In extreme cases this can make exercise and breathing very difficult. In fact, the only famous recorded case of an athlete having the condition is Cody Miller CHANGE SLIDE, an American swimmer who chose not to have any treatment despite it having an impact on his physical ability.
Treatments
In a lot of cases, pectus excavatum does not need to be treated as the indentation it creates is not deep enough to cause any damage to other organs or most importantly the spine. For mild cases, simply exercising and doing specific chest stretches can be enough to permanently fix the condition, there are even websites set up specifically for this purpose, however for more severe cases there are two main types of surgery. The Ravitch procedure is the most invasive surgery, and is not widely practiced any more unless in very extreme cases CHANGE SLIDE. It involves making an incision vertically down the chest and detaching the sternum. A metal bar is then slotted underneath the ribs in order to act as a sort of brace (sometimes even replacing a deformed rib), forcing the cartilage on the chest to grow back into a normal position. After around 6 months to a year the bar is then removed by another surgery procedure CHANGE SLIDE, however it leaves a large scar on the chest, possibly undermining the purpose of the whole procedure. The second technique, which is far less invasive, is the Nuss procedure CHANGE SLIDE. This involves making two much smaller incisions on the sides of the chest and pushing a U-shaped bar through the intercostal muscles to the same position, under the sternum . It is then flipped around so that it pushes outwards on the chest, forcing it back to a normal position CHANGE SLIDE and taking anywhere from 2-5 years to be fully complete. Whilst being a lot less invasive and painful than the previous method, it also takes almost 10 times as long. For some reason finding pictures of a before and after for the ravitch procedure is difficult, so instead i found a picture of straight after the operation and after the wound has fully healedCHANGE SLIDE. As you can see the scar is still very noticeable, hence why I think this operation is fundamentally flawed. You are replacing a noticeable chest condition with a noticeable chest scar, which will not help any psychological issues that may have been caused by it. The nuss procedure CHANGE SLIDE however has a vast effect, both physically and psychologically, leaving minimal scarring or any noticeable defects of any kind. However there are a number of problems with this outside of the operation. Due to immense stress on the NHS at this point in time, other more serious operations are often given precedence. Often an operation on the chest can be cancelled at the last minute, despite the waiting times of more than a year. This has effected me personally, and multiple people I know who have had to wait upwards of three years to finally gain access to the operation. Despite this, I think that the images on the previous two slides show just how far this operation has come, and also shows the advances the medical community as a whole has made and is still making. Breakthroughs have been made that have improved the medical capabilities of the world, and I’m sure similar discoveries can and will be made in many other fields of medicine.