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Chest Wall Deformity

Checked: 23-03-2020 by Rob Adams Next Review: 23-03-2021

Overview

Pectus deformity is a term used to describe a group of conditions associated with the malformation of the chest wall. In most cases, a pectus deformity will be present at birth, however, it will usually only become obvious and visible during early adolescence, when growth is rapid. Diagnosis is made by physical examination.

There are two main types of pectus deformity:

• Pectus excavatum, in which the breastbone is sunken inwards and the chest looks hollow. Sometimes this is called "funnel chest". This is the most common type of deformity; and

• Pectus carinatum, in which the breastbone is raised and the chest is pushed out. Sometimes this is called "pigeon chest".

The impact of a pectus deformity can vary substantially, ranging from mild and asymptomatic to severe and impacting on both lung (pulmonary) and heart (cardiac) function. Psychologically, the deformity usually has little impact, but in some cases it can cause psychological distress leading to concerns about appearance, withdrawal and social isolation.

Referral

Surgery for chest wall deformity for cosmetic reasons is subject to an exceptional funding policy (for children and adults)

Correction of Chest Wall Deformity for Cosmetic Purposes Exceptional Funding Request Policy

Referrals for surgery for psychological reasons will not normally be considered and exceptional funding would have to be obtained if a referral is to be accepted for this reason. Reassurance should be given and patients can be referred for psychological support using existing services if necessary.

If there are concerns about respiratory or cardiac conditions as a result of a chest wall deformity then a referral to the appropriate respiratory or cardiac clinic should be made as appropriate (no funding required). If surgery is then required this will be under a NHS England policy. GPs should therefore not be using this route to apply for funding themselves as this should be done in secondary care if required.

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