Abstract
With the triumphal march of the surgical method (MIRPE) in the correction of pectus excavatum deformities, according to Donald Nuss [6] the method originally described by Ravitch in 1949 and 1958 [9, 10] was partially dislodged into the background and minor scope was left for special applications only. However the Ravitch technique is still widely used as a standard procedure in the correction of pectus carinatum deformities (Chapter 7.1) Although a recent study consisting of a systematic review and meta-analysis methodology confirmed that the complication rate in the MIRPE technique is higher than in the Ravitch technique, and the period of requirement of postoperative analgesics seems to be lower than in the MIRPE collectives, a clear difference concerning the aesthetic outcome could not be elaborated. It seems that particularly the parameters of pain and aesthetic result, being of paramount importance for the patient self, could not be studied comparatively due to too many biasing factors and lack of long-term comparability [1, 5]. Despite that the MIRPE technique offers a method requiring far shorter surgery time and represents an overall elegant method with however pleasing results lasting for many years. The elegancy and straightforward technique in experienced hands with relatively hidden scars supported its triumphal march so far, convincing patients and surgeons as well. However, these findings are predominantly true for children and adolescents, but must be regarded differentiated in adults. For the latter collective of patients no comparative data are yet available.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Boehm RA, Muensterer OJ, Till H (2004) Comparing minimally invasive funnel chest repair versus the conventional technique: an outcome analysis in children. Plast Reconstr Surg 114:668–673. Discussion by Nuss D. 674–675
Javangula KC, Batchelor TJ, Jaber O, Watterson KG, Papagiannopoulos K (2006) Combined severe pectus excavatum correction and aortic root replacement in Marfan’s syndrome. Ann Thorac Surg 81:1913–1915
Kumar UK, Sahasranam KV (1991) Mitral valve prolapse syndrome and associated thoracic skeletal abnormalities. J Assoc Physician India 39:536–539
Länsman S, Serlo W, Linna O, Pohjonen T, Törmälä P, Waris T, Ashammakhi N (2002) Treatment of pectus excavatum with bioabsorbable polylactide plates: preliminary results. J Pediatr Surg 37:1281–1286
Nasr A, Fecteau A, Wales PW (2010) Comparison of the Nuss tehnique and the Ravitch procedure for pectus excavatum repair: a meta-analysis. J Pediatr Surg 45: 880–886
Nuss D, Kelly RE Jr, Croitoru DP, Katz ME (1998) A 10 year review of a minimally invasive technique for the correction of pectus excavatum. J Ped Surg 33: 545–552
Okay T, Ketenci B, Imamoglu OU, Aydemir B, Tuygun AK, Ozay B, Yapici F, Corah TK, Demirtas MM (2008) Simultaneous open-heart surgery and pectus deformity correction. Surg Today 38:592–596
Park JM, Varma SK (1990) Pectus excavatum in children: diagnostic significance for mitral valve prolapse. Indian J Pediatr 57:219–222
Ravitch MM (1949) The operative treatment of pectus excavatum. Ann Surg 129:429–444
Ravitch MM (1958) Operation for correction of pectus excavatum. Surg Gynecol Obstet 107:619–623
Ryu YG, Baek MJ, Kim HK, Choi YH, Sohn YS, Kim HJ (2009) Simultaneous repair for aortic incompetence with annuloaortic ectasia and pectus excavatum by modified Ravitch procedure with pectus bars in an adult patient with Marfan syndrome. J Thorac Cardiovasc Surg 137:e34–e36
Salomon J, Shah PM, Heinle RA (1975) Thoracic skeletal abnormalities in idiopathic mitral valve prolapse. Am J Cardiol 36:32–36
Scherer LR, Arn PH, Dressel DA, Pyeritz RM, Haller JA Jr (1988) Surgical management of children and young adults with Marfan syndrome and pectus excavatum. J Pediatr Surg 23:1169–1172
Schwabegger AH, Harpf C Ninkovic M, Rieger M (2002) Technical refinements in planning and surgical therapy of pectus carinatum. Chirurg 73:1191–1196
Schwabegger AH, Jeschke J, Schuetz T, Del Frari B (2008) Refinements in pectus carinatum correction: the pectoralis muscle split technique. J Pediatr Surg 43:771–774
Seliem MA, Duffy CE, Gidding SS, Berdusis K, Benson DW Jr (1992) Echocardiographic evaluation of the aortic root and mitral valve in children and adolescents with isolated pectus excavatum: comparison with Marfan patients. Pediatr Cardiol 13:20–23
Zoeller GK, Zallen GS, Glick PL (2005) Cardiopulmonary resuscitation in patients with a Nuss bar — a case report and review of the literature. J Pediatr Surg 40: 1788–1971
References
Adkins PC, Blades B (1961) A stainless steel strut for correction of pectus excavatum. Surg Gynecol Obstet 113:111–113
Fonkalsrud EW, Beanes S, Hebra A, Adamson W, Tagge E (2002) Comparison of minimally invasive and modified Ravitch pectus excavatum repair. J Pediatr Surg 37:413–417
Fonkalsrad EW, Medoza J, Finn PJ, Cooper CB (2006) Recent experience with open repair of pectus excavatum with minimal cartilage resection. Arch Surg 141: 823–829
Gotzen L, Dragojevic D (1979) Funnel chest correction by use of AO implants and instruments. Thorac Cardiovasc Surg 27:61–64
Gürkök S, Genc O, Dakak M, Balkanli K (2001) The use of absorbable material in correction of pectus deformities. Eur J Cardio Thorac Surg 19:711–712
Haller JA Jr, Shermeta DW, Tepas JJ, Bittner HR, Golladay ES (1978) Correction of pectus excavatum without prosthesis or splints: objective measurement of severity and management of asymmetrical deformities. Ann Surg 26:73–79
Haller JA Jr, Scherer LR, Turner CS, Colombani PM (1989) Evolving management of pectus excavatum based on a single institutional experience of 664 patients. Ann Surg 209:578–582
Hegemann G, Leutschaft R (1965) Die operative Behandlung der Trichtebrast. Thoraxchirurgie 13:281–287
Hümmer HP, Klein P, Simon S (1992) Techniken und Erfahrungen mit Trichterbrustoperationen. Langenbecks Arch Chir Suppl (Kongressbericht) 241: 401–409
Länsman S, Serlo W, Linna O, Pohjonen T, Törmälä P, Waris T, Ashammakhi N (2002) Treatment of pectus excavatum with bioabsorbable polylactide plates: preliminary results. J Pediatr Surg 37:1281–1286
Karagounis VA, Wasnick J, Gold JP (2004) An innovative single-stage repair of severe asymmetric pectus excavatum defects using substernal mesh bands. Ann Thorac Surg 78:e19–e21
Kellomäki M, Niiranen H, Puumanen K, Ashammakhi N, Waris T, Törmälä P (2000) Bioabsorbable scaffolds for guided bone regeneration and generation. Biomaterials 21:2495–2505
Luzzi L, Voltolini L, Zacharias J, Campione A, Ghiribelli C, Di Bisceglie M, Gotti G (2004) Ten year experience of bioabsorbable mesh support in pectus excavatum repair. Brit J Plast Surg 57:733–740
Matsui T, Kitano M, Nakanuro T, Shimigu Y, Hyon SH, Ikado Y (1994) Bioabsorbable struts made from poly L-lactide and their application for treatment of chest deformity. J Thorac Cardiovasc Surg 108:162–168
Nakanishi Y, Nkajima T, Skakibara A, Nishiyama T (1992) A vascularised rib strut technique for funnel chest correction. Brit J Plast Surg 45:364–366
Rehbein F, Wernicke HH (1957) The operative treatment of the funnel chest. Arch Dis Child 32:5–8
Robicsek F, Fokin A (1999) Surgical correction of pectus excavatum and carinatum. J Cardiovasc Surg 40: 725–731
Robicsek F (2000) Surgical treatment of pectus excavatum. Chest Surg Clin North Am 10:277–297
Schwabegger AH, Piza H (2005) Free sternum turnover flap for correction of pectus excavatum deformity. Plast Reconstr Surg 116:1182
Saxena AK, Schaarschmidt K, Schleef J, Morcate JJ, Willital GH (1999) Surgical correction of pectus excavatum: the Münster experience. Langenbeck Arch Surg 384:187–193
Saxena AK, Willital GH (2007) Valuable lessons from two decades of pectus repair with the Willital-Hegemann procedure. J Thorac Cardiovasc Surg 134: 871–876
Schwabegger AH, Jeschke J, Schuetz T, Del Frari B (2008) Refinements in pectus carinatum corrections: the pectoralis muscle split technique. J Pediatr Surg 43: 771–774
Watanabe Y, Takashi I (1984) Surgical correction of pectus excavatum for adults and adolescents. Jpn J Surg 14:472–478
Willital GH (1981) Operationsindikation — Operationstechnik bei Brustkorbdeformierungen. Z Kinderchir 33:244–252
References
Martinez D, Stein JJ, Pena A (1990) The effect of costal cartilage resection on chest wall development. Pediatr Surg Int 5:70–73
Haller JA, Colombani PM, Humphries CT et al (1996) Chest wall constriction after too extensive and too early operations for pectus excavatum. Ann Thorac Surg 61:1618–1625
Nuss D, Kelly RE Jr, Croitoru DP, Swoveland B (1998) Repair of pectus excavatum. Pediatr Endosurg Innovat Tech 2:205–221
Nuss D, Kelly RE Jr, Croitoru DP, Katz ME (1998) A 10 year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 33:545–552
Croitoru DP, Nuss D, Kelly RE, Goretsky MJ, Swoveland B (2002) Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in over 303 patients. J Pediatr Surg 37:437–445
Hebra A, Swoveland B, Eqheal M et al (2000) Outcome analysis of minimally invasive repairs of pectus excavatum: review of 251 cases. J Pediatr Surg 35:252–258
Miller KA, Wood RK, Sharp RJ et al (2001) Minimally invasive repair of pectus excavatum: a single institution’s experience. Surgery 130:652–659
Hosie S, Sitkiewicz T, Peterson C et al (2002) Minimally invasive repair of pectus excavatum — the Nuss procedure. A European multicenter experience. Eur J Pediatr Surg 12:235–238
Uemura S, Choda Y (2003) Nuss procedures for pectus excavatum and the operative results. Jpn J Pediatr Surg 35:665–671
Park JH, Lee SY, Lee CS et al (2004) The Nuss procedure for pectus excavatum: evolution of technique and early results on 322 patients. Ann Thorac Surg 77: 289–295
Ravitch MM (1949) The operative treatment of pectus excavatum. Ann Surg 129:429–444
Welch KJ (1958) Satisfactory surgical correction of pectus excavatum deformity in childhood. J Thorac Surg 36:697–713
Lawson ML, Cash TF, Akers R et al (2003) A pilot study of the impact of surgical repair on disease specific. Quality of life among patients with pectus excavatum. J Pediatr Surg 38:916–918
Rushing GD, Goretsky MJ, Gustin T, Morales M, Kelly RE Jr, Nuss D (2007) When it’s not an infection: metal allergy after the Nuss procedure for repair of pectus excavatum. J Pediatr Surg 42:93–97
Krasopoulos G, Dusmet M et al (2006) Nuss procedure improves the quality of life in young male adults with pectus excavatum deformity. Eur J Cardiothorac Surg 29:1–5
Coln D, Gunning T et al (2002) Early experience with the Nuss minimally invasive correction of pectus excavatum in adults. World J Surg 10:1217–1221
Hendrickson RJ, Bensard DD, Jarick JS, Patrick DA (2005) Efficacy of left thoracoscopy and blunt mediastinal dissection during the Nuss procedure for pectus excavatum. J Pediatr Surg 40:1312–1314
Hebra A et al (2001) A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum. J Pediatr Surg 36(8):1266–1268
Kelly RE Jr, Shamberger RC, Mellins RB et al (2007) Prospective multicenter study of surgical correction of pectus excavatum. J Am Coll Surg 205:205–216
Lawson ML, Mellins RB, Tabangin M, Kelly RE Jr, Croitoru DP, Goretsky MJ, Nuss D (2005) Impact of pectus excavatum on pulmonary function before and after repair with Nuss procedure. J Pediatr Surg 40:174–180
References
Al-Assiri A, Kravarusic D, Wong V, Dicken B, Milbrandt K, Sigalet DL (2009) Operative innovation to the “Nuss” procedure for pectus excavatum: operative and functional effects. J Pediatr Surg 44:888–892
Cheng YL, Lee SC, Huang TW, Wu CT (2008) Efficacy and safety of modified bilateral thoracoscopy-assisted Nuss procedure in adult patients with pectus excavatum. Eur J Cardiothorac Surg 34:1057–1061
Coln D, Gunning T, Ramsay M, Swygert T, Vera R (2002) Early experience with the Nuss minimally invasive correction of pectus excavatum in adults. World J Surg 26:1217–1221
Croitoru DP, Nuss D, Kelly RE, Goretsky MJ, Swoveland B (2002) Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in over 303 patients. J Pediatr Surg 37: 437–445
Fang FC, Cheng YL, Lee SC, Chen JC, Hsu HH, Tzao C (2008) Clinical experience of Nuss procedure for pectus excavatum in adult female patients. Thorac Cardiovasc Surg 56:283–286
Fonkalsrud EW, Bustorff-Silva J (1999) Repair of pectus excavatum and carinatum in adults. Am J Surg 177:121–124
Fonkalsrud EW, Dunn JCY, Atkinson JB (2000) Repair of pectus excavatum deformities: 30 years of experience with 375 patients. Ann Surg 231:443–448
Fonkalsrud EW, DeUgarte D, Choi E (2002) Repair of pectus excavatum and carinatum deformities in 116 adults. Ann Surg 236:304–314
Fonkalsrud EW, Reemtsen B (2002) Force required to elevate the sternum of pectus excavatum patients. J Am Coll Surg 195:575–577
Fonkalsrud EW (2004) Open repair of pectus excavatum with minimal cartilage resection. Ann Surg 240: 231–235
Genc O, Gurkok S, Gözübüyük A, Dakak M, Caylak H, Yücel O (2006) Repair of pectus deformities: experience and outcome in 317 cases. Ann Saudi Med 26: 370–374
Goretsky MJ, Kelly RE Jr, Croitoru D, Nuss D (2004) Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med Clin 15:455–471
Hebra A, Gauderer MWL, Tagge EP, Adamson WT, Othersen HB Jr (2001) A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum. J Ped Surg 36:1266–1268
Hirayama T, Nozaki M, Wakamatsu S (1985) A new surgical method for repair of funnel chest. Ann Plast Surg 14:213–223
Hosie S, Sitkiewicz T, Petersen C, et al. (2002) Minimally invasive repair of pectus excavatum — the Nuss procedure. A European multicentre experience. Eur J Pediatr Surg 12:235–238
Ishikawa S, Uchinuma E, Itoh M, Shioya N (1998) A simple sternal turnover procedure using a vascular pedicle for a funnel chest. Ann Plast Surg 20: 485–491
Jensen K, Schmidt R, Caramella J, Lynch M (1970) Pectus excavatum: the how, when and why of surgical correction. J Pediatr Surg 5:4–13
Kasagi Y, Kasagi M, Matsuoka A (2008) Submuscular Nuss procedure using mammary areola incision for adult pectus excavatum with significant upper chest depression. Kyobu Geka 61:1126–1129
Krasopoulos G, Dusmet M, Ladas G, Goldstraw P (2005) Nuss procedure improves the quality of life in young male adults with pectus excavatum deformity. Eur J Cardiothorac Surg 29:1–5
Leonhardt J, Kübier JF, Feiter J, Ure BM, Petersen C (2005) Complications of the minimally invasive repair of pectus excavatum. J Pediatr Surg 40:e7–e9
Michlits W, Windhofer C, Papp C (2009) Pectus excavatum and free fasciocutaneous infragluteal flap: a new technique for the correction of congenital asymptomatic chest wall deformities in adults. Plast Reconstr Surg 124:1520–1528
Nagasao T, Miyamoto J, Ichihara K, Jiang H, Jin HM, Tamaki T (2010) Age-related change of postoperative pain location after Nuss procedure for pectus excavatum. Eur J Cardiothorac Surg 38:203–209
Nagaso T, Miyamonto J, Kokaji K, Yozu R, Jiang H, Jin HM, Tamaki T (2010) Double-bar application decreases postoperative pain after the Nuss procedure. J Thorac Cardiovasc Surg 140:39.e2–44.e2
Nasr A, Fecteau A, Wales PW (2010) Comparison of the Nuss and the Ravitch procedure for pectus excavatum repair: a meta-analysis. J Pediatr Surg 45:880–886
Ninkovic M, Schwabegger AH, Gardetto A, Moser-Rumer A, Rieger M, Ninkovic M, Rainer C (2003) Free sternum turnover flap for correction of pectus excavatum deformity. Plast Reconstr Surg 112:1355–1361
Nuss D, Kelly RE Jr, Croitoru DP, Katz ME (1998) A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 33: 545–552
Ong CC, Choo K, Morreau P, Auldist A (2005) The learning curve in learning the curve: a review of Nuss procedure in teenagers. ANZ J Surg 75:421–424
Ostlie DJ, Marosky JK, Spilde TL, et al. (2003) Evaluation of pectus bar position and osseous bone formation. J Pediatr Surg 38:953–956
Park HJ, Lee SY, Lee CS (2004) Complications associated with the Nuss procedure. Analysis of risk factors and suggested measures for prevention of complications. J Pediatr Surg 39:391–395
Pilegaard HK, Licht PB (2008) Routine use of minimally invasive surgery for pectus excavatum in adults. Ann Thorac Surg 86:952–956. Comment in: Ann Thorac Surg 86:957
Protopapas AD, Athanasiou T (2008) Peri-operative data on the Nuss procedure in children with pectus excavatum: independent survey of the first 20 years’ data. J Cardiothorac Surg 3:40–44
Raab N, Holm-Muehlbauer C, Ninkovic M (2009) Free superficial inferior epigastric artery flap for aesthetic correction of mild pectus excavatum. Plast Reconstr Surg 123:209e–211e
Ravitch MM (1949) The operative treatment of pectus excavatum. Ann Surg 122:429–444
Saxena AK, Schaarschmidt K, Schleef J, Morcate JJ, Willital GH (1999) Surgical correction of pectus excavatum: the Münster experience. Langenbecks Arch Surg 384:187–193
Schalamon J, Pokall S, Windhaber J, Hoellwarth ME (2006) Minimally invasive correction of pectus excavatum in adult patients. J Thorac Cardiovasc Surg 132:524–529
Schwabegger AH, Jeschke J, Schuetz T, Del Frari B (2008) Refinements in pectus carinatum corrections: the pectoralis muscle split technique. J Pediatr Surg 43:771–774
Shamberger RC (1996) Congenital chest wall deformities. Curr Prob Surg 33:469–552
Tang Chen YB, Chen JS, Lee YC, Huang KF, Chen HC (1999) Revascularization of turnover sternum: a definitive treatment for intractable funnel chest. Microsurgery 19:296–302
Uemura S, Nakagawa Y, Yoshida A, Choda Y (2003) Experience in 100 cases with the Nuss procedure using a technique for stabilization of the pectus bar. Pediatr Surg Int 19:186–189
Watanabe Y, Takashi I (1984) Surgical correction of pectus excavatum for adults and adolescents. Jpn J Surg 14:472–478
Weber PG, Huemmer HP, Reingruber B (2006) Forces to be overcome in correction of pectus excavatum. J Thorac Cardiovasc Surg 132:1369–1373
Yoon YS, Kim HK, Choi YS, Kim K, Shim YM, Kim J (2010) A modified Nuss procedure for late adolescents and adult pectus excavatum. World J Surg 34:1475–1480
References
Murray JF (1965) Correction of pectus excavatum by synthetic subcutaneous implant. Presented at the American Society of Plastic and Reconstructive Surgery, Philadelphia, October 1965
Bailey BN (1977) Pectus excavatum: masking with silastic RTV 382 vulcanised in situ. Br J Plast Surg 30:227–230
Brack JC, Hörtnagl H, Bauer M, Wilflingseder P (1982) A fresh approach in the treatment of pectus excavatum. Chir Plast 6:263–274
Lemperle G, Exner K (1983) Die Behandlung der Trichterbrust mit RTV-Silikon-Implantaten. Handchir Mikrochir Plast Chir 15:154–157
Lavey E, Apfelberg DB, Lash H, Maser MR, Laub DR, Gosain A (1982) Customized silicone implants of the breast and chest. Plast Reconstr Surg 69:646–651
Rose EH, Lavey EB (1982) Correction of bilateral breast hypoplasia and pectus excavatum with single-unit customized silicone implant. Plast Reconstr Surg 72:234–236
Marks MW, Argenta LC, Lee DC (1984) Silicone implant correction of pectus excavatum: indications and refinement in technique. Plast Reconstr Surg 74:52–58
Wechselberger G, Öhlbauer M, Haslinger J, Schoeller T, Bauer T, Piza-Katzer H (2001) Silicone implant correction of pectus excavatum. Ann Plast Surg 47:489–493. Erratum in: Ann Plast Surg (2001) 47:611
Snel BJ, Spronk CA, Werker PMN (2009) Pectus excavatum reconstruction with silicone implants: long term results and a review of the English-language-literature. Ann Plast Surg 62:205–209
Horch RE, Stoelben E, Carbon R, Sultan AA, Bach AD, Kneser U (2006) Pectus excavatum breast and chest deformity: indications for aesthetic plastic surgery versus thoracic surgery in a multicenter experience. Aesthetic Plast Surg 30:403–411
Borges AF (1984) Relaxed skin tension lines (RSTL) versus other skin lines. Plast Reconstr Surg 73:144–150
Wilhelmi BJ, Blackwell SJ, Phillips LG (1999) Langer’s lines: to use or not to use. Plast Reconstr Surg 104: 208–214
Marks MW, Iacobucci J (2000) Reconstruction of congenital chest wall deformities using solid silicone onlay prostheses. Chest Surg Clin North Am 10:341–355
Hougaard G, Svensson H, Holmqvist KG (1995) Casting the implant for reconstruction of pectus excavatum. Scand J Plast Reconstr Surg Hand Surg 29:227–231
Hedén P, Sellmann G, von Wachenfeldt M, Olenius M, Fagrell D (2009) Body shaping and volume restoration: the role of hyaluronic acid. Aesthetic Plast Surg 33: 274–282
Narins RS, Dayan SH, Brandt FS, Baldwin EK (2008) Persistence and improvement of nasolabial fold correction with nonanimal-stabilized hyaluronic acid 100,000 gel particles/ml filler on two treatment schedules: results up to 18 months on two retreatment schedules. Dermatol Surg 34(Suppl 1):S2–S8
Nordquist J, Svensson H, Johnsson M (2001) Silastic implant for reconstruction of pectus excavatum: an update. Scand J Plast Reconstr Surg Hand Surg 35: 65–69
Hodgkinson DJ (1997) Chest wall implants: their use for pectus excavatum, pectoralis muscle tears, Poland’s syndrome and muscular insufficiency. Aesthetic Plast Surg 21:7–15
Horch RE, Springer O (2002) Minimally invasive endoscopic correction of funnel chest deformity via an umbilical incision. Aesthetic Plast Surg 26: 295–298
Grappolini S, Fanzio PM, D’Addetta PG, Todde A, Infante M (2008) Aesthetic treatment of pectus excavatum: a new endoscopic technique using a porous polyethylene implant. Aesthetic Plast Surg 32: 105–110
References
Arslan E, Majka C, Polat A (2007) The fate of diced cartilage grafts of traumatized versus nontraumatized origin. Aesthetic Plast Surg 31:365–371
Calvert JW, Brenner K, DaCosta-Iyer M, Evans GRD, Daniel RK (2006) Histological analysis of human diced cartilage grafts. Plast Reconstr Surg 118:230–236
Çelik M, Haliloglu T, Bayçin N (2004) Bone chips and diced cartilage: an anatomically adopted graft for the nasal dorsum. Aesthetic Plast Surg 28:8–12
Coskun BU, Seven H, Yigit O, Alkan S, Savk H, Basak T, Dadas B (2005) Comparison of diced cartilage graft wrapped in Surgicell and diced cartilage graft wrapped in fascia: an experimental study. Laryngoscope 115: 668–671
Daniel RK, Calvert JW (2004) Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 113: 2156–2171
Elahi MM, Jackson IT, Andrea Moreira-Gonzalez A, Yamini D (2003) Diced cartilage: a review of 67 consecutive cases. Plast Reconstr Surg 111:1309–1318
Erol OO (2000) The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 105:2229–2241
Schwabegger AH, Engelhardt TO, Jeschke J (2008) Stabilization of microvascular pedicles in intricate locations using fibrin glue. Microsurgery 28:509–513
Yilmaz S, Ercocen AR, Can Z, Yenidunya S, Edali N, Yormuk E (2001) Viability of diced, crushed cartilage grafts and the effects of Surgicel (oxidized regenerated cellulose) on cartilage grafts. Plast Reconstr Surg 108:1054–1060
References
Bruning P (cited in Broeckhaert TJ) (1919) Contribution a l’étude des greffes adipeuses. Bull Acad R Med Belg 28:440–444
Calabria R (2005) Fat grafting: fact or fiction? Aesthetic Surg 25:55
Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthetic Plast Surg 19:421–425
Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367
Coleman SR (2001) Structural fat grafts: the ideal filler? Clin Plast Surg 28:111–119
Coleman SR (2002) Hand rejuvenation with structural fat grafting. Plast Reconstr Surg 110:1745–1747
Coleman SR (2003) Structural lipoaugmentation. In: Narins RS (ed) Safe liposuction and fat transfer. Marcel Dekker, New York, pp 409–423
Coleman SR (2001) Structural fat grafts: the ideal filler? Clin Plast Surg 28:111–119
Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118(Suppl): 108–120
Ellenbogen R (1986) Free autogenous pearl fat grafts in the face: a preliminary report of a rediscovered technique. Ann Plast Surg 16:179–194
Fournier PF (1991) Liposculpture: the syringe technique. Arnette-Blackwell, Paris
Garcia-Olmo D, Garcia-Arranz M, Herreros D et al (2005) A phase I clinical trial of the treatment of Crohn’s fistula by adipose mesenchymal stem cell transplantation. Dis Colon Rectum 48:1416–1423
Guerrerosantos J (2000) Long-term outcome of autologous fat transplantation in aesthetic facial recontouring. Clin Plast Surg 27:515–543
Jackson IT, Simman R, Tholen R et al (2001) A successful long-term method of fat grafting: recontouring of a large subcutaneous postradiation thigh defect with autologous fat transplantation. Aesthetic Plast Surg 25:165–169
Kaminer MS, Omura NE (2001) Autologous fat transplantation. Arch Dermatol 137:812–814
Kaufmann MR (2007) Autologous fat transfer for facial recontouring. Is there science behind the art? Plast Reconstr Surg 119:2287–2296
Moscona R, Ullman Y, Har-Shai Y, Hirshowitz B (1989) Free-fat injections for the correction of hemifacial atrophy. Plast Reconstr Surg 84:501–507
Peer LA (1950) Loss of weight and volume in human fat grafts. Plast Reconstr Surg 5:217–230
Peer LA (1956) The neglected free fat graft. Plast Reconstr Surg 18:233–241
Pereira LH (2008) Free fat transplantation fort he aesthetic correction of mild pectus excavatum. Aesthetic Plast Surg 32:393–396
Pierrefeu-Lagrance AC, Delay E, Guerin N et al (2006) Evaluation radiologique des seins reconstruits ayant beneficie d’un lipomodelage. Ann Chir Plast Esthet 51:18–28
Pinski KS, Roenigk HH (1992) Autologous fat transplantation: long-term follow-up. J Dermatol Surg Oncol 18:179–184
Pinsolle V, Chichery A, Grolleau JL, Chavoin JP (2008) Autologous fat injection in Poland’s syndrome. J Plast Reconstr Aesthetic Surg 61:784–791
Rigotti G, Marchi A, Galie M et al (2007) Clinical treatment of radiotherapy tissue damages by lipoaspirates transplant: a healing process mediated by adipose derived stem cells. Plast Reconstr Surg 119: 1409–1422
Schmeller W (2003) Autologer Fetttransfer. Hautarzt 54:1185–1189
Sommer B, Sattler G (2000) Current concepts of fat graft survival: histology of aspirated adipose tissue and review of the literature. Dermatol Surg 26:1116–1159
References
Adams WP Jr, Lipschitz AH, Ansari M, Kenkel JM, Rohrich RJ (2004) Functional donor site morbidity following latissimus dorsi muscle flap transfer. Ann Plast Surg 53:6–11
Arnold PG, Pailorero PC (1995) Chest-wall reconstruction: an account of 500 consecutive cases. Plast Reconstr Surg 98:804–810
Grappolini S, Fanzio PM, D’Addetta PG, Todde A, Infante M (2008) Aesthetic treatment of pectus excavatum: a new endoscopic technique using a porous polyethylene implant. Aesthetic Plast Surg 32: 105–110
Guimarães J, Maia M, Monteiro E, Ferraro A (2001) Aesthetic correction of mild pectus excavatum with autologous tissue during mastopexy. Plast Reconstr Surg 108:757–761
Marshall DR, Anstee EJ, Stapleton MJ (1981) Post mastectomy breast reconstruction using a breast sharing technique. Br J Plast Surg 34:426–430
Morestin H (1907) Hypertrophie mammaire traitée par la resection discoide. Bull Soc Chir Paris 33:605
Nakanishi Y, Nkajima T, Skakibara A, Nishiyama T (1992) A vascularised rib strut technique for funnel chest correction. Br J Plast Surg 45:364–366
Piza-Katzer H (2003) Transverse resection: a new technique of reduction mammoplasty. Br J Plast Surg 56: 365–368
Ross R (1986) Buried transverse abdominal myocuta-neous flap and silicone implants to reconstruct pectus excavatum and bilateral mastectomy deformity. Plast Reconstr Surg 78:817–819
Schmidt M, Aszmann OC, Beck H, Frey M (2010) The anatomic basis of the internal mammary artery perforator flap: a cadaver study. J Plast Reconstr Aesthetic Surg 63:191–196
Schoeller T, Bauer T, Haug M, Wechselberger G, Piza-Katzer H (2001) A new contralateral split-breast flap for breast reconstruction and its salvage after complication: an alternative for select patients. Ann Plast Surg 47:442–445
Vesely MJJ, Murray DJ, Novak CB, Gullane PJ, Neligan PC (2007) The internal mammary artery perforator flap. Ann Plast Surg 58:156–161
Yu P, Roblin P, Chevray P (2006) Internal mammary artery perforator (IMAP) flap for tracheostoma reconstruction. Head Neck 28:723–729
Yamamoto Y, Sugihara T (1997) Aesthetic correction of mild funnel chest with autologous tissue augmentation. Plast Reconstr Surg 99:892–894
Weinzweig N, Yetman R (1995) Transposition of the greater omentum for recalcitrant median sternotomy wound infections. Ann Plast Surg 34:471–477
References
Lacquet LK, Morshuis WJ, Folgering HT (1998) Long term results after correction of anterior chest wall deformities. J Cardiovasc Surg 39(5):683–688
Shamberger RC, Welch KJ (1988) Cardiopulmonary function in pectus excavatum. Surg Gynecol Obstet 166:383–391
Ravitch MM (1949) The operative treatment of pectus excavatum. Ann Surg 129:429–436
Willital GH (1981) Indication and operative technique in chest deformities. Z Kinderchir 33(3):244–252
Adkins PC, Blades B (1961) A stainless steel strut for correction of pectus excavatum. Surg Gynecol Obstet 111:111–113
Nuss D, Kelly RE Jr, Croitoru DP et al (1998) A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 33:545–552
Ninkovic M, Schwabegger A, Gardetto A et al (2003) Free sternum turnover flap for correction of pectus excavatum deformity. Plast Reconstr Surg 112(5): 1355–1361
Marks MW, Iacobucci J (2000) Reconstruction of congenital chest wall deformities using silicone onlay prostheses. Chest Surg Clin North Am 10(2):341–355
Chavoin JP, Dahan M, Grolleau JL et al (2003) Funnel chest: filling technique with deep custom made implants. Ann Chir Plast Esthet 48(2):67–76
Yamamoto Y, Sugihara T (1997) Aesthetic correction of mild funnel chest with autologous tissue augmentation. Plast Reconstr Surg 99(3):892–894
Rudolph R (2002) Pectus excavatum repair with TRAM flap. Plast Reconstr Surg 110(1):352
Hougaard G, Svensson H, Holmqvist KG (1995) Casting the implant for reconstruction of pectus excavatum. Scand J Plast Reconstr Surg Hand Surg 29:227–231
Papp C, Todoroff BP, Windhofer C et al (2003) Partial and complete reconstruction of Achilles tendon defects with the fasciocutaneous infragluteal free flap. Plast Reconstr Surg 112:777–783
Papp C, Windhofer C, Gruber S (2007) Breast reconstruction with the fasciocutaneous infragluteal free flap (FCI). Ann Plast Surg 58:131–136
Windhofer C, Brenner E, Moriggl B et al (2002) Relationship between the descending branch of the inferior gluteal artery and the posterior femoral cutaneous nerve applicable to flap surgery. Surg Radiol Anat 24:253–257
Frick A, Baumeister RGH, Wiebecke B (1993) Microvasculature of the inferior gluteal flap. Eur J Plast Surg 16:30–32
Onishi K, Maruyama Y (2001) Correction of pectus excavatum using a sternal elevator: preliminary report. Br J Plast Surg 54:117–124
References
Adkins PC, Blades B (1961) A stainless steel strut for correction of pectus excavatum. Surg Gynecol Obstet 113:111–113
Daunt SW, Cohen JH, Miller SF (2004) Age-related normal ranges for the Haller index in children. Pediatr Radiol 34:326–330
Fonkalsrud EW, Dunn JC, Atkinson JB (2000) Repair of pectus excavatum deformities: 30 years of experience with 375 patients. Ann Surg 231:443–448
Haller JA Jr, Colombani PM, Humphries CT, Azizkhan RG, Loughlin GM (1996) Chest wall constriction after too extensive and too early operations for pectus excavatum. Ann Thorac Surg 61:1618–1624
Haller JA Jr, Loughlin GM (2000) Cardiorespiratory function is significantly improved following corrective surgery for severe pectus excavatum. Proposed treatment guidelines. J Cardiovasc Surg 41:125–130
Hefel L, Schwabegger AH, Ninkovic M, Wechselberger G, Moriggl B, Waldenberger P, Anderl H (1995) Internal mammary vessels: anatomical and clinical considerations. Brit J Plast Surg 48:527–532
Hirayama T, Nozaki M, Wakamatsu S (1985) A new surgical method for repair of funnel chest. Ann Plast Surg 14:213–223
Ishikawa S, Uchinuma E, Itoh M, Shioya N (1998) A simple sternal turnover procedure using a vascular pedicle for a funnel chest. Ann Plast Surg 20:485–491
Jung A (1956) Treatment of funnel chest by the peduncle turning method of the sternochondral basin. Mem Acad Chir (Paris) 82:242–249
Jung A, Lang G, Kehr P, Jung F, Paternotte H (1975) Uber die chirurgische Behandlung der Trichterbrust. Die gestielte Umwendeplastik. Z Orthop Ihre Grenzgeb 113: 830–833
Ninkovic M, Anderl H, Hefel L, Schwabegger AH, Wechselberger G (1995) Internal mammary vessels: a reliable recipient system for free flaps in breast reconstruction. Brit J Plast Surg 48:533–539
Ninkovic MM, Schwabegger AH, Anderl H (1998) Internal mammary vessels as a recipient site. Clin Plast Surg 25:213–221
Ninkovic M, Schwabegger AH, Gardetto A, Moser-Rumer A, Rieger M, Ninkovic M, Rainer C (2003) Free sternum turnover flap for correction of pectus excavatum deformity. Plast Reconstr Surg 112:1355–1361
Nuss D, Kelly RE Jr, Croitoru DP, Katz ME (1998) A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg 33: 545–552
Raab N, Holm-Muehlbauer C, Ninkovic M (2009) Free superficial inferior epigastric artery flap for aesthetic correction of mild pectus excavatum. Plast Reconstr Surg 123:209e–211e
Ravitch MM (1949) The operative treatment of pectus excavatum. Ann Surg 122:429–444
Rehbein F, Wernicke HH (1957) The operative treatment of the funnel chest. Arch Dis Child 32:5–8
Saxena AK, Schaarschmidt K, Schleef J, Morcate JJ, Willital GH (1999) Surgical correction of pectus excavatum: the Münster experience. Langenbecks Arch Surg 384:187–193
Saxena AK, Willital GH (2007) Valuable lessons from two decades of pectus repair with the Willital-Hegemann procedure. J Thorac Cardiovasc Surg 134: 871–876
Schwabegger AH, Ninkovic MM, Moriggl B, Waldenberger P, Brenner E, Wechselberger G, Anderl H (1997) Internal mammary veins: classification and surgical use in free-tissue transfer. J Reconstr Microsurg 13:17–23
Schwabegger AH, Moriggl B, Waldenberger P, Hefel L, Ninković M, Brenner E, Anderl H (1998) Die Vasa mammaria interna als Empfängergefasse in der rekonstruktiven Mikrochirurgie im Thoraxbereich: anatomisch-radiologische Studie. Handchir Mikrochir Plast Chir 30:87–94
Schwabegger AH, Bodner G, Rieger M, Jaschke WR, Ninkovic MM (1999) Internal mammary vessels as a model for power Doppler imaging of recipient vessels in microsurgery. Plast Reconstr Surg 104:1656–1665
Schwabegger AH, Harpf C, Ninkovic M, Rieger M (2002) Technische Neuerungen in der Planung und Therapie der Kielbrust-Deformität. Volume rendering CT und resorbierbare Osteosynthesematerialien. Chirurg 73: 1191–1196
Schwabegger AH, Piza H (2005) Free sternum turnover flap for correction of pectus excavatum deformity. Plast Reconstr Surg 116:1182
Taguchi K, Mochizuki T, Nagagaki M, Kato K (1975) A new plastic operation for pectus excavatum: sternal turnover surgical procedure with preserved internal mammary vessels. Chest 67:606–608
Tang Chen YB, Chen JS, Lee YC, Huang KF, Chen HC (1999) Revascularization of turnover sternum: a definitive treatment for intractable funnel chest. Microsurgery 19:296–302
Toth T, Szots I, Forgon J, Zaborsky A (1986) Surgical treatment of pectus excavatum by “turn-over” of the sternum. Zentralbl Chir 111:1515–1518
Wada J, Ikeda K, Ishida T, Hasegawa T (1970) Results of 271 funnel chest operations. Ann Thorac Surg 10: 526–532
Wechselberger G, Rumer A, Schoeller T, Schwabegger AH, Ninkovic M, Anderl H (1997) Monitoring of free flaps with tissue oxygen pressure measurement. J Reconstr Microsurg 13:125–130
References
Arn PH, Scherer LR, Haller JA Jr, Pyeritz RE (1989) Outcome of pectus excavatum in patients with Marfan Syndrome and the general population. J Pediatr 115: 954–958
Doty DB, Hawkins JA (1983) A turnover operation for pectus excavatum at the time of correction of intracardiac defects. J Thorac Cardiovasc Surg 86:787–790
Okay T, Ketenci B, Imamoglu OU, Aydemir B, Tuygun AK, Ozay B, Yapici F, Corah TK, Demirtas MM (2008) Simultaneous open-heart surgery and pectus deformity correction. Surg Today 38:592–596
Redlinger RE, Rushing GD, Moskowitz AD, Kelly RE Jr, Nuss D, Kuhn A, Obermeyer RJ, Goretsky MJ (2009) Minimally invasive repair of pectus excavatum in patients with Marfan syndrome and marfanoid features. J Pediatr Surg 45:193–199
Tschirkov A, Baev B, Iliev R (2000) Simultaneous pectus and open heart surgery. Chest Surg Clin North Am 10: 405–413
Willekes CL, Backer CL, Mavroudis C (1999) A 26-year review of pectus deformity repairs, including simultaneous intracardiac repair. Ann Thorac Surg 67: 511–518
Zoeller GK, Zallen GS, Glick PL (2005) Cardiopulmonary resuscitation in patients with a Nuss bar — a case report and review of the literature. J Pediatr Surg 40: 1788–1971
References
Bento L, Martinez MA, Conde J, Pérez A, Chueca M (2006) Empleo de la campana de succión en el tratamiento del pectus excavatum [The vacuum chest wall lifter in the treatment of pectus excavatum]. Cir Pediátr 19(1):46–48
Haecker FM, Mayr J (2006) The vacuum bell for treatment of pectus excavatum: an alternative to surgical correction Eur J Cardiothorac Surg 29(4):557–561
Haje SA, Bowen JR (1992) Preliminary results of orthotic treatment of pectus deformities in children and adolescents. J Pediatr Orthop 12(6):795–800
Morger R (1984) Konservative und operative Behandlung der Trichterbrust. Z Kinderchir 39:302–304
Schier F, Bahr M, Klobe E (2005) The vacuum chest wall lifter: an innovative, nonsurgical addition to the management of pectus excavatum. J Pediatr Surg 40(3): 496–500
Spitzy H, Lange F (1930) Handbuch der Kinderheilkunde. In: Pfaundler von M, Schlossmann A (eds) Band 8: Orthopädie im Kindesalter. Verlag von F.C.W. Vogel, Leipzig, pp 196–197
Reference
Watanabe A, Watanabe T, Obama T, Ohsawa H, Mawatari T, Ichimiya Y, Abe T (2003) The use of a lateral stabilizer increases the incidence of wound trouble following the Nuss procedure. Ann Thorac Surg 77:296–300
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this chapter
Cite this chapter
Schwabegger, A.H. et al. (2011). Special techniques in the funnel chest deformity. In: Schwabegger, A.H. (eds) Congenital Thoracic Wall Deformities. Springer, Vienna. https://doi.org/10.1007/978-3-211-99138-1_6
Download citation
DOI: https://doi.org/10.1007/978-3-211-99138-1_6
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-99137-4
Online ISBN: 978-3-211-99138-1
eBook Packages: MedicineMedicine (R0)