Sternal cleft and pectus excavatum: an overlooked congenital association?
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In brief
In brief
This retrospective study of 8 sternal cleft patients found 87.5% had concomitant pectus excavatum, suggesting a much higher association than previously reported (2.6-5%). The authors propose that pectus excavatum may be congenitally linked to sternal cleft rather than repair-induced, recommending concurrent prevention or treatment during sternal cleft correction.
- Pectus excavatum occurs in 87.5% of sternal cleft patients, far exceeding the 2.6-5% reported in literature.
- Sternal cleft patients show significantly abnormal pre-operative Correction Index, suggesting congenital PE predisposition.
- PE may become more apparent after sternal cleft repair as the child grows, not necessarily caused by the repair itself.
- Concurrent PE prevention or treatment should be considered during sternal cleft repair procedures.
- The association between sternal cleft and pectus excavatum is likely underestimated in current medical literature.
Written by the GCMD Library team from the article.
Abstract
Background
Sternal cleft (SC), a rare thoracic malformation, is associated with pectus excavatum (PE) in 2.6–5% of cases. It remains unclear if these conditions are congenitally linked or if SC repair triggers PE. To investigate the potential higher frequency of PE in SC cases, we conducted a retrospective study of our SC patients.
Methods
We assessed PE incidence, progression, and management in SC patients treated at our institute from 2006 to 2022. When available, we collected pre-SC repair CT scan data, calculating the Haller Index (HI) and Correction Index (CI) and compared them to a selected control group.
Results
Among 8 SC patients, 7 had concomitant PE (87.5%), varying in severity. PE management ranged from observation to thoracoplasty, depending on its degree. We observed a significant pre-operative CI difference between SC and control group patients (p < 0.00001). In the last two SC repair cases, we attempted concurrent PE prevention or treatment.
Conclusion
Our findings suggest an underestimated association between PE and SC in the existing literature. SC patients may exhibit a predisposition to PE from birth, which may become more apparent with growth after SC repair. Consequently, PE prevention or treatment should be considered during SC repair procedures.