Chest Wall Deformities

This chapter focuses on chest wall deformities, including their pathoetiology, presentation, workup, and management. Pectus excavatum is the most common chest wall deformity characterized by a posterior depression of the sternum with variable severity. While patients with pectus excavatum may request a cosmetic repair, there is likely a component of restoration of cardiopulmonary function in patients with severe defects. Surgical techniques for pectus excavatum most commonly involve an open resection of the costal cartilages with sternal reconstruction (Ravitch procedure) or placement of a curved metal bar under the sternum (Nuss procedure). Thoracic outlet syndrome (TOS) is another chest wall process characterized by compression of the neurovascular structures of the thoracic outlet resulting in a varied presentation of pain and paresthesias of the upper extremity, depending on the affected anatomy. This chapter presents an overview of the etiology, diagnosis, and treatment options for chest wall deformities and highlights the importance of early intervention for improved outcomes.