Determination of severity of deformity with rib length to costal cartilage  length ratio in thorax deformities

Karakılıç, Ali; Karaçam, Volkan; Ersöz, Hasan; Ağababaoğlu, İsmail; Ulugün, Fatma İlknur; Şanli, Aydın

doi:10.5606/tgkdc.dergisi.2018.15009

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…Sweet [1944], on the other hand, hypothesized that the deformity was due to an overgrowth of the costal cartilage ( 40 ). The costal cartilage overgrowth hypothesis has however been brought into question by the results of studies on costal cartilage lengths measured using three-dimensional (3D)-computed tomography (CT) images ( 46 - 49 ). While the costal cartilage overgrowth hypothesis assumes that costal cartilage lengths are longer at the site of overgrowth, these studies showed an indifferent or even shorter costal cartilage length when compared to the contralateral costal cartilage or the cartilage of healthy individuals.…”

Section: Pectus Excavatummentioning

confidence: 99%

“…While the costal cartilage overgrowth hypothesis assumes that costal cartilage lengths are longer at the site of overgrowth, these studies showed an indifferent or even shorter costal cartilage length when compared to the contralateral costal cartilage or the cartilage of healthy individuals. Karakılıç et al [2018], found no correlation between the costal cartilage length and the severity of the deformity ( 49 ). On the contrary, Park et al [2015] and Kondo et al [2020] observed longer than normal costal cartilage in pectus excavatum patients, leaving the costal cartilage overgrowth hypothesis a controversial topic ( 50 , 51 ).…”

Section: Pectus Excavatummentioning

confidence: 99%

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Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification

Janssen,

Coorens,

Franssen

et al. 2024

J Thorac Dis

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Background and Objective A wide variety of congenital chest wall deformities that manifest in infants, children and adolescents exists, among which are pectus excavatum and pectus carinatum. Numerous studies have been conducted over the years aiming to better understand these deformities. This report provides a brief overview of what is currently known about the epidemiology, etiopathogenesis, clinical presentation, and classification of these deformities, and highlights the gaps in knowledge. Methods A search was conducted for all the above-described domains in the PubMed and Embase databases. Key Content and Findings A total of 147 articles were included in this narrative review. Estimation of the true incidence and prevalence of pectus excavatum and carinatum is challenging due to lacking consensus on a definition of both deformities. Nowadays, several theories for the development of pectus excavatum and carinatum have been suggested which focus on intrinsic or extrinsic pathogenic factors, with the leading hypothesis focusing on overgrowth or growth disturbance of costal cartilages. Furthermore, genetic predisposition to the deformities is likely to exist. Pectus excavatum is frequently associated with cardiopulmonary symptoms, while pectus carinatum patients mostly present with cosmetic complaints. Both deformities are classified based on the shape or severity of the deformity. However, each classification system has its limitations. Conclusions Substantial progress has been made in the past few decades in understanding the development and symptomatology of pectus excavatum and carinatum. Current hypotheses on the etiology of the deformities should be confirmed by biomedical and genetic studies. For clinical purposes, the establishment of a clear definition and classification system for both deformities based on objective morphologic features is eagerly anticipated.

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Section: Pectus Excavatummentioning

confidence: 99%

Section: Pectus Excavatummentioning

confidence: 99%

Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification

Janssen,

Coorens,

Franssen

et al. 2024

J Thorac Dis

View full text Add to dashboard Cite

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“…Besides the histologic and genetic studies, there are several imagistic studies assessing the morphology of the rib cage in relation to the origin of PE in humans. It seemed logical for several authors that, if the excessive growth of the costal cartilages is the cause of sternal depression, then the incriminated costal cartilages must be longer than normal [ 108 , 109 , 110 , 111 , 112 , 113 , 114 ]. However, the results of these studies are rather divergent.…”

Section: The Anatomopathological and Biomechanical Perspectivesmentioning

confidence: 99%

“…Nakaoka et al (2009) found that the ribs and costal cartilages on the side with a more severe depression are shorter or equal than those on the opposite side in asymmetric PE [ 106 ]. When comparing the lengths of the costal cartilages on CT images of PE to normal, Nakaoka et al (2010), David et al (2016), and Karakilic et al (2018) found that there are no differences [ 109 , 110 , 111 ]. Besides this, Karakilic et al (2018) found no significant correlation between the length of the costal cartilages and the severity of the PE, evaluated by the Haller index [ 111 ].…”

Section: The Anatomopathological and Biomechanical Perspectivesmentioning

confidence: 99%

“…When comparing the lengths of the costal cartilages on CT images of PE to normal, Nakaoka et al (2010), David et al (2016), and Karakilic et al (2018) found that there are no differences [ 109 , 110 , 111 ]. Besides this, Karakilic et al (2018) found no significant correlation between the length of the costal cartilages and the severity of the PE, evaluated by the Haller index [ 111 ]. Moreover, Eisinger et al (2019) found shorter than normal costal cartilages in patients with PE [ 112 ].…”

Section: The Anatomopathological and Biomechanical Perspectivesmentioning

confidence: 99%

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Current Concepts in the Etiology and Pathogenesis of Pectus Excavatum in Humans—A Systematic Review

David

2022

JCM

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Pectus excavatum (PE) is the most common deformity of the chest wall and is characterized by the posterior depression of the sternum and the lower costal cartilages. To date, the etiology of PE in humans remains enigmatic. Several etiologic hypotheses have been proposed over the past two centuries. However, most of them have been scientifically dismissed and now have only historic value. In this systematic review, we assess scientific publications of the past two centuries addressing the issue of the origin of PE in humans. We present and discuss the histologic, genetic, biomechanical, and experimental scientific achievements that contributed to the clarification of its etiology and pathogenesis. With no clear consensus over the exact mechanism, most recent studies agree that the primordial defect leading the deformation of the anterior chest wall in PE is related to the costal hyaline cartilage structure and function. Further studies on this subject must be carried out. Genetic studies seem to be the most promising way to understand the exact mechanism of PE’s origin and pathogenesis.

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Magnetic resonance imaging in the evaluation of pectus excavatum

Muzafarova,

Vishnyakova,

Abramenko

et al. 2024

Digital Diagnostics

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Relevance: Magnetic resonance imaging (MRI) is more often used to confirm the presence of pectus excavatum then to assess compression changes in the heart at this level. Purpose: preoperative evaluation of PE according to magnetic resonance imaging. Materials and methods: A retrospective evaluation of chest MRI was performed in 38 patients (30 males, 8 females). The average age is 19.9 years (+/- 9 years).Cardiac MRI was performed on 1.5T General Electric Optima MR450w GEM scanner with 2D-FIESTA-C pulse sequences with functional assessment of left and right ventricles. Parameters for surgical treatment of PE were obtained - the Haller index, the correction index, the sternum rotation angle.Statistical search for the relationship between Haller index, correction index, sternum rotation angle and ejection fraction of the right ventricle was held. A value less than 0.05 was considered statistically significant.Results: In 92% of cases moderate and severe PE were diagnosed. No statistically significant correlation was obtained (P=0.777) between the values of the Haller index and the fraction of the right ventricle. When distinguishing three PE degrees according to the Haller index, a gradual decrease in the average value of the right ventricular ejection fraction was noted - for patients with mild PE, the fraction was 48%, for moderate deformity - 47%, for severe deformity 43%. Correlation between the values of the Haller index and the correction index (p0.05) was noted. The value of the angle of rotation of the sternum, which required modification of surgical intervention was detected in 44.7% of patients. Conclusion: Magnetic resonance imaging is an informative diagnostic method for PE without radiation exposure with the possibility of detailed preoperative assessment. Correlation between the values of the Haller index and the correction index (p0.05) was noted. MRI revealed a decrease in the ejection fraction of the right ventricle.

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Determination of severity of deformity with rib length to costal cartilage length ratio in thorax deformities

Cited by 3 publications

References 20 publications

Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification

Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification

Current Concepts in the Etiology and Pathogenesis of Pectus Excavatum in Humans—A Systematic Review

Magnetic resonance imaging in the evaluation of pectus excavatum

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