Funnel chest is a congenital abnormality of the chest where the center of the chest is depressed, rather than protruding out. Many cases are mild and create no problems, other than aesthetic distress for the patient. In others, the sunken chest puts pressure on the heart and lungs, creating difficulty breathing, as well as heart problems. Surgery is available to treat this condition, although it is usually only considered an option in cases where the patient is having health problems.
Known formally as pectus excavatum, funnel chest can appear on its own or in association with another congenital condition like Marfan syndrome. It is caused by an excess in the growth of the connective tissue around the chest, pulling the center of the chest downwards. Mild cases often clear up on their own, with an infant's chest gradually developing outwards with time. Other patients can have severe funnel chest and as the name suggests, the deformity does indeed sometimes look like a funnel planted in the middle of the chest.
People who have trouble breathing, cannot exercise, or experience heart problems may be evaluated for surgery. Medical imaging studies can be taken to see if the depressed chestbone is pressing down on the contents of the chest cavity. Historically, procedures were very invasive and required reconstructive surgery on the chest. Today, many patients have a less invasive surgery known as the Nuss procedure, where a stabilizing bar is inserted through the side of the chest and flipped to push the chestbone out. After several years, the bar can be removed and the chest should remain stable.
This musculoskeletal disorder may sometimes cause patients to be unhappy with the physical appearance of the chest, although there is no impairment in function. For these patients, more mild surgery may be offered as an option for correcting the way the chest looks, without the invasive and painful options involved for patients who have severe funnel chest. A surgeon can discuss the risks and benefits with a patient to reach a decision on the best treatment option.
Recovery from funnel chest surgery is lengthy, no matter which procedure is used. Patients usually spend several days on bed rest, must do breathing exercises to strengthen the lungs, and are required to restrict their physical activities for weeks or months. Patients preparing for surgery should fully discuss the aftercare so they know what to expect before the surgery takes place.