Beacon Pectus Clinic
Beacon for Kids Pectus Clinic is the only clinic of its kind in Ireland. The clinic offers a non-invasive treatment for chest wall deformities.
Beacon Pectus Clinic is a specialised service providing the most innovative non-invasive treatment for children with chest wall deformities. Consultant Paediatric Surgeon, Mr Brice Antao, offers this service exclusively Ireland. Mr Antao has over 12 years’ experience in the management of chest wall deformities in the USA, the UK and Ireland.
The Pectus is a chest wall deformity which makes the chest wall appear abnormally shaped. It is present from birth but often only becomes apparent in early adolescence.
There are two main types of pectus deformities:
This is also known as ‘sunken’ or ‘funnel’ chest. This is where the breast bone is pushed abnormally inwards and the chest appears caved-in or sunken. This condition affects around 1 in 300 people. Males are three times more likely than females to suffer from the condition.
Also known as ‘pigeon chest’, this is where the breast bone is pushed outwards. The condition affects 1 in 1000 people with males being four times more likely to suffer from the condition.
The exact cause of pectus deformities is unknown, though it’s largely attributed to abnormal cartilage overgrowth between the bony ribs and sternum (breast bone). This excess cartilage can cause the breast bone to protrude or sink. Although no genetic link has been found, pectus deformities do appear to run in families. Some other conditions such as Poland Syndrome or Marfan’s Syndrome can also lead to these pectus deformities.
The presence of symptoms varies depending on the severity of the defect. The majority of patients are free from symptoms, though some suffer from back pain, chest pain or breathlessness upon physical exertion.
The most common symptom is unhappiness at the appearance of the deformity which can have a significant psychological impact on the patient’s self-esteem, body image and self-confidence.
Other symptoms sometimes seen are:
Abdomen and Pelvis
The abdomen can sometimes appear to be protruding (pot belly). This can be due to poor muscle and pelvic tines and may be exaggerated by the lower rib cage appearing to stick out (rib flaring) and interior pelvic tilt.
Associated abnormalities of coastal margins (ribcage) are often seen in children with pectus deformities. This typically affects the lower ribs and lower edge of the ribcage causing lower ribs and the coastal margin either on one of both sides to stick out (rib flaring) or to be pulled in (rib flattening).
Head and Neck Issues
In many pectus children, the head appears to be pushed forward and the neck excessively flexed. This is partly due to the altered gravity caused by the pectus defect in addition to the tight pectoralis muscles and weakened upper back muscles.
The shoulders may be uneven with one appearing to sit lower than the other. In some cases, there is a lateral rotation of the shoulder which can cause protrusion of the shoulder blades (scapular winging).
Spinal problems are often seen in children with pectus deformities. These include excessive outward curvature of the spine (Scheurmann’s Syndrome or Juvenile Kyphosis), kyphosis of the head and neck, lordosis of the lower spine and scoliosis.
Non-surgical treatments for Pectus deformities
Pectus Bracing for Pectus Carinatum
Compressive orthoses (pectus braces) are designed to place external forces on the point of the most prominent sternal protrusion of the deformity. This provides continued pressure to stimulate bone and cartilage remodelling. The treatment is performed in Beacon for Kids Outpatient Department and does not involve and cuts, surgery or scarring.
Beacon for Kids is the first and only centre in Ireland to provide this treatment which the American Paediatric Surgical Association recommends as the first line in treating Pectus Carinatum.
Treatment includes a custom-made brace along with chest-wall manipulation, tailored exercise and posture management program, regular brace adjustment and close monitoring of progress.
Patient compliance, close monitoring and diligent follow-up and key to the success of pectus bracing treatments.
Vacuum Bell Therapy for Pectus Excavatum
Vacuum Bell Therapy offers a non-surgical treatment of Pectus Excavatum. The vacuum bell is a suction cup used to create a vacuum on the chest wall in order to pull the sternum out.
The device needs to be worn for several hours each day and the treatment monitored over 12 to 18 months. Exercise programs tailored for the patient will help to reverse some of the effects of pectus such as weak muscles, loss of flexibility, rib flaring and poor posture.
Patients with pectus deformities often suffer from poor self-esteem and impaired body image. At Beacon for Kids Pectus Clinic, we are able to offer psychological support and counselling for such patients to better cope with their condition and improve their self-esteem.