Some problems related to mild cases of pectus excavatum, such as posture and shoulder issues, may be helped by physical therapy. Surgery is recommended to correct moderate to severe cases of pectus excavatum.
Surgery is recommended for two main reasons:
The ideal time to perform surgery is during the adolescent growth spurt (ages 11 to 14), before bone and the fibrous connective tissue between the ribs (cartilage) mature. The surgery also can be performed successfully in adults.
Pediatric and chest (thoracic) surgeons at Mayo Clinic are skilled at performing the two main treatments for pectus excavatum: a minimally invasive surgery (the Nuss procedure) or open-chest surgery.
The Nuss procedure is more commonly performed on children and adolescents. Mayo Clinic surgeons have extensive experience with this technique, in which a curved steel bar is placed under the chest wall and rotated into position, pushing out the sunken chest. The average hospital stay is under five days and most children are back in school within two weeks.
Mayo surgeons also perform the Nuss procedure on adults. The procedure can also be used on people who have undergone a previous open surgery that failed to correct the deformity. Mayo surgeons use a thoracoscope to help safely guide the bar and avoid the heart.
A number of studies have compared these two methods of correcting pectus excavatum. Overall, they report that both successfully correct the problem with minimal complications.
Read more about treatment of pectus excavatum.