Indications for surgical repair of funnel chest based on indices of chest wall deformity and psychological state.
OBJECTIVE
We examined the surgical indications for funnel chest, taking psychological factors into consideration.


METHODS
We assessed 36 young people with funnel chest who were seen as outpatients, including 31 boys and 5 girls aged from 1 to 22 years old. Respondents were asked whether they suffered psychological distress, and if they wanted surgery. The severity of the deformity was evaluated using the Vertebral Index (VI) and the Frontosagittal Index (FSI) calculated from chest roentgenograms.


RESULTS
The VI in 11 patients without distress (23.7 +/- 4.1) was lower than that in 25 patients with distress (32.8 +/- 8.2), and the FSI in the patients without distress (33.5 +/- 5.3) was higher than that in the patients with distress (23.6 +/- 8.6). The VI in 19 patients who did not want surgery (26.9 +/- 7.9) was lower than that in 17 patients who did (33.5 +/- 7.5), and the FSI in the patients who did not want surgery (30.4 +/- 8.1) was higher than that in the patients who did (22.4 +/- 8.1). The distressed patients suffered many psychological problems, such as being the object of bullying.


CONCLUSIONS
The severity of the deformity affected the patient's psychological state. We consider that a VI >28 or an FSI <28 are indications for surgery, based on the mean VI + SD and the mean FSI-SD of patients not suffering distress.
Ohno
Koichi
K
Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Morotomi
Yoshiki
Y
Nakahira
Masashi
M
Takeuchi
Satoshi
S
Shiokawa
Chizuka
C
Moriuchi
Takayoshi
T
Harumoto
Ken
K
Nakaoka
Tatsuo
T
Ueda
Masanao
M
Yoshida
Tatsuyuki
T
Yamada
Hiroto
H
Tsujimoto
Kasuke
K
Kinoshita
Hiroaki
H
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005660:Funnel Chest / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D008297:Male; D019637:Orthopedic Procedures; D010347:Patient Care Planning; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological