An Open, Prospective Study to Evaluate the Effectiveness and Safety of Hyaluronic Acid for Pectus Excavatum Treatment

Abstract

Background Pectus excavatum (PE) is sometimes associated with psychological and physiological difficulties influencing a patient’s quality of life. Treatment with a hyaluronic acid (HA)-based gel may benefit patients and be an alternative to other more invasive treatments. Objectives The authors sought to evaluate the effectiveness in terms of satisfaction, duration, and safety of HA gel treatment for PE including impact on quality of life. Methods Males ≥18 years having PE without functional problems received HA gel injections (50 – 150 mL) at the site of deformity and in some cases at the medial pectoralis muscle borders to optimize the aesthetic result. Follow-up visits were performed after 1, 3, 6, 12, and 24 months with optional retreatment at the 24-month visit including a 1-month follow-up. Evaluations included Pectus Excavatum Evaluation Questionnaire, patient satisfaction, magnetic resonance imaging, and safety assessments. Results The treatment significantly improved patients’ self-esteem ( P < 0.001) and psychosocial function ( P ≤ 0.038) throughout the study, as assessed by Pectus Excavatum Evaluation Questionnaire. Patients were satisfied with the aesthetic outcome and considered the treatment mild in terms of level of pain during injection. Treatment effects were maintained up to 24 months and 58% of the HA gel remained at this visit, shown by Magnetic Resonance Imaging measurements. The treatment was well tolerated. Conclusions Treatment of PE with HA gel improved patient quality of life related to self-esteem and psychosocial functioning including aesthetically pleasing results. The treatment may also offer benefits in terms of safety and tolerability compared with other treatments. Level of Evidence: 4

Autologous Ear Reconstruction and 3D Printing, an Innovative Hybrid Surgical-engineering Reconstructive Approach for Custom-made Ear Models: Our Experience

“…The median score of satisfaction according to the adapted version of Hedén and Sinna 20 was 9.5 out of 11 (IQR, 7–10.25). Six of 12 patients graded their satisfaction level over 10 out of 11.…”

“…Patient variables included demographics, primary diagnosis, affected ear, microtia classification according to Marx classification, 19 auditory function, associated malformations, surgical time, length of hospitalization, complications, aesthetic results, and patients’ level of satisfaction using specific questionnaires adapted from Hedén and Sinna, 20 and are shown in Table 1. Only 12 of 17 patients were considered eligible for the satisfaction questionnaire.…”

“…Questionnares were adapted from Hedén and Sinna20 ; the last three were excluded because of short follow-up.…”

Can a Breast Augmentation Procedure Improve the Appearance of Pectus Excavatum Deformity in Female Patients? A Prospective Study

“…28,33 These implants, though, have an increased cost and a less natural feeling due to their solid quality. 34 Lately, hyaluronic acid [35][36][37] has also been reported as a possible treatment option. However, it is a material that can be less stable in the thoracic area, leading to unpleasant under-the-skin visibility of the product, and it could require multiple sessions to achieve the desired result.…”

Reliability and validity of the Chinese revised version of the pectus excavatum evaluation questionnaire in children with pectus excavatum

“…The PEEQ investigates the degree of specific sensations or the frequency of specific behaviors of the patient in the last month [ 5 ], and can be applied to children before and after corrective surgery [ 1 ]. The PEEQ and its adult version, the NUSS assessment questionnaire (NQ-mA), modified by Krasopoulos and his team [ 6 ], have been widely used in clinical studies related to PE [ 5 , 7 – 10 ]. They are commonly accepted as assessment tools for evaluating QOL of patients with PE.…”