Dermal-Filler.us

Pectus excavatum

Signs and symptoms
The characteristic of the condition is a hollow aspect of the sternum. The heart can move and rotate / O. mitral valve prolapse may also be present. Base diminished lung capacity.
Causes
Currently, researchers do not know the real cause pectus excavatum, but the hypothesis of a genetic defect. About 37% of people have pectus excavatum member of the family the disease in first grade. Physiologically, increasing pressure on the uterus, rickets and increased traction on the sternum due to abnormalities of the membrane is postulated mechanisms and specific. The pectus excavatum is a relatively common symptom of Marfan syndrome. Many children with spinal muscular pectus excavatum developed due to diaphragmatic breathing that is common with the disease.
Pathophysiology
Because the heart is located behind the sternum, and because individuals with pectus excavatum was shown that visible deformities of the heart (as seen in both images and X-ray after the autopsy) is the assumption that there is a deterioration of the function cardiovascular system in people with pectus excavatum. Although some studies have shown decreased cardiovascular function in pectus excavatum, no consensus has been based in new physiological tests (such as echocardiography) the presence or the degree of impairment of cardiovascular function in people with pectus excavatum. Similarly, no consensus on the degree of functional improvement after corrective surgery.
Diagnosis
Cross section analysis of a chest with pectus excavatum
The pectus excavatum was first suspected on visual inspection of the anterior chest. Chest auscultation may be displaced heart and valve prolapse. There may be a heart murmur during systole that occur because the proximity of the sternum and the pulmonary artery. lung sounds usually are clear even decreased due to the basis of decreased lung capacity.
scales have been developed to determine the degree of deformation of the chest wall. Most of them are variations on the distance between the sternum and spine. An index of this type is a relationship between the severity of the deformity degrees based on the relationship Backer between the vertebral body diameter of the nearest exit and spacing xiphosternal Union and as close to the vertebral body xiphosternal. More recently, the index Haller has been used in CT. An index of more than 3.25 is usually defined as serious. The Haller index is the ratio of the horizontal distance from inside the rib cage and the shortest distance between the vertebrae and sternum.
X-rays are also useful in diagnosis. The lung x-ray may showing an opacity in the right lung area to be confused with an infiltrate (As seen with pneumonia). Some studies also suggest the Haller index can be calculated on the basis of chest X-ray scanner, compared with people who have no limitations in function.
Excavatum Chest Unlike other disorders by removing a series of signs and symptoms. Pectus carinatum is precluded by the mere observation of a sternum collapse rather than a projection. kyphoscoliosis Excluding the imaging of the spine, where pectus excavatum column is usually normal in structure.
Treatment
The treatment of pectus excavatum may have invasive or noninvasive techniques or a combination of both. Before an operation, the product of several tests are usually performed. These include, but not limited to, the analysis of CT, pulmonary function tests and cardiology tests (such as auscultation and ECG). After a CT scan takes Haller index measured. The patient Haller is calculated by taking the ratio of transverse diameter (the distance horizontally within the rib cage) and anteroposterior (The shortest distance between the vertebrae and sternum). A Haller index more than 3.25 is generally regarded as serious, whereas the normal breast has a score of 2.5. cardiovascular tests are used to determine lung capacity and see heart murmur.
Surgery
Surgical correction has been shown the repair of the functional symptoms that may occur in diseases such as respiratory problems or heart murmurs, provided that no permanent damage has arisen an extremely serious case.
Ravitch technique
Ravitch technique is an invasive surgery was introduced in 1949 and developed in the 1950s to treat condition. This procedure involves creating an incision in the chest through which the cartilage is removed and separated sternum. A small bar is inserted under the sternum to hold it in position. The bar is left there until the cartilage to grow back, usually about six months. The bar is then removed in a procedure Administrative simple. Ravitch technique is not widely practiced because it is very invasive. It is often used in elderly patients, when calcified sternum, when the strain is asymmetric, or less invasive Nuss has been successful. [Citation needed]
Nuss procedures
Main article: Nuss Procedure
Lung exercises, use after corrective surgery to prevent pneumonia and to increase the base capacity of the lung
X-ray of a man 15 years after undergoing the Nuss procedure
Since then, Dr. Donald Nuss, based at Children's Hospital of The King's Daughters (CHKD) in Norfolk, Virginia, has developed a technique that is minimally invasive. The Nuss procedure involves sliders in one or more concave steel in the chest beneath the breastbone. The bar becomes in a convex position to grow outward on the sternum, correcting the deformity. The bar usually stays in the body for about two years, although many surgeons are about to leave to a maximum of five years. When bones become solid in place, the bar is removed through outpatient surgery.
Vacuum Costilla Bell and compressors
See also: Vacuum bell (medicine)
A relatively new alternative to surgery is a vacuum chamber. It consists of a bowl-shaped device that fits stranded in the region, air is extracted by a hand pump. The vacuum created by the student with the sternum, reduce the severity of the deformity. As if a recent device is currently no information on whether it is effective in the long term. Use side of the compressor using a suction device 7 "has proven effective in the correction of pectus excavatum permanent. The ribs are compressed, while the sternum is lifted by a small suction device 7 "This sets the ribs in the desired position and resolve the situation is the sternum.
Cosmetics and light treatments
The aesthetic appearance of pectus excavatum may be the skin treated with a charge called Bio-Alcamid. However, this did nothing to alleviate the current burden to prevent symptoms caused by physiological the disease.
Mild cases have also been treated with support, such as brakes and exercise.
Prostheses are also available to fill the empty space. Silicone implants have been used successfully for many years with acceptable results in some cases. More recently, implants have been used Porex is a material used to replace similar brain surgery in the skull and severe head injuries.
magnetic mini-mover procedure
The mini-motor procedure magnetic (3MP) is a technique used to correct the pectus excavatum with two magnets realign the sternum with the rest of the chest and ribs. A magnet is inserted 1 cm patient's body at the lower end of the sternum, the other is out on a support are available upon request. These two magnets generate around 0.04 tesla (T) crawl to the outside of the sternum for several years. The maximum magnetic field that can be safely applied on the body is about 4 T, which makes this safe technique and magnetic point of view. main advantages of the technique is that 3MP is more profitable than the outline of the approach and the Nuss procedure is an operation less painful. One of the potential adverse effects 3MP is the inactivation of implantable devices such as pacemakers, artificial. In 3MP is still in a probationary period not known whether long-term to reduce the magnet affect the skin or other organs.
Epidemiology
The pectus excavatum occurs in approximately 1 in every 150-1000 births with a male predominance (ratio / female ratio of 3:1). The case of the disease among family members was reported in 35% to 45% of cases.
In animals
The pectus excavatum is also known to occur in animals, for example, the Munchkin cat breed. Some procedures used to treat the condition of the animals are used in humans, such as the use of a source with sutures wrapped around the sternum and the use of internal and external splints. These techniques are generally used in immature animals of flexible cartilage.
See also
The pectus carinatum
References
Lexicographers ^ Douglas M. Head Anderson (2003) pectus excavatum (28th ed.) Medicla Dorland Dictionary: Saunders, ISBN 0721601464, http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ ppdocs / us / Common / Dorland / Dorland / nine/000955637.htm
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^ "How to measure the Haller. Department of Cardiology and Pulmonology Clinic http://www.scielo.br/pdf/jbpneu/v30n6/en_a03v30n6.pdf Hospital da Faculdade de Medicina, University of So Paulo sector of Thoracic Surgery "(PDF) ..
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References
Wikipedia on pectus excavatum
Search for pectus in Wiktionary, the dictionary.
Open Pectus excavatum Project Directory
EV
Congenital and deformations of musculoskeletal system and musculoskeletal abnormalities (Q65-Q76, 754 to 756.3)
Salas /
dysmelia
Top
collarbone and shoulders cleidocranial dysostosis Sprengel deformity Wallis Zieff Goldblatt syndrome
deformity of the hand deformity Polydactyly oligodactyly Clinodactyly Madelung
Lower
hip: Dislocation of hip disease, hip dysplasia, coxa valga coxa vara Upington
Knee Genu valgus genu varum
Clubfoot: Pes cavus foot Club foot flat rock
Or both as a
dactyly / numbers: Polydactyly / syndactyly (webbed fingers) Arachnodactyly Lenz ectrodactyly syndactyly dining brachydactyly
deficit reduction / Share: Acheiropodia ectromelia (phocomelia, Amelia, hemimelia)
multiple joints: syndrome, Larsen syndrome of arthrogryposis Rapadilino
Craniofacial
Craniosynostosis: scaphocephaly Oxycephaly Trigonocephaly
Craniofacial dysostosis: Crouzon syndrome Hallermann-Streiff syndrome hypertelorism, Treacher Collins syndrome
other: Macrocephaly Platybasia dolichocephaly nose Greig dysplasia syndrome Plagiocephaly Craniodiaphyseal Saddle
Other axial
spine: spinal curvature (scoliosis) the Klippel-Feil syndrome, spondylolisthesis, spina bifida occulta
ribs: Cervical rib bifid ribs
sternum: Pectus carinatum pectus excavatum
common paths: anat arthropathies, non-congenital and strain / Dorsopathies / soft tissue defects arthropathy or samples of the same name, proc
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