Airway deformation in patients demonstrating pectus excavatum with an improvement after the Nuss procedure.
OBJECTIVE
This study analyzed the inside appearance of the trachea and the main bronchus at the time of performing the Nuss procedure to test the hypothesis that the trachea and the main bronchus might be deformed by compression from great vessels due to sternal depression.


METHODS
A retrospective cohort study included 36 patients with pectus excavatum, who were treated using the Nuss procedure between July 2001 and December 2009. The primary outcome measures were the oblateness of the trachea and bilateral main bronchus. The oblateness in patients with pectus excavatum was compared with that of the control group. Their postoperative changes and the relationship between the Haller CT index were also analyzed.


RESULTS
The oblateness of the trachea and the left main bronchus in patients with pectus excavatum was significantly greater than that of the control group. A negative correlation was recognized between the percent vital capacity and the oblateness of the left main bronchus. The oblateness of the bilateral main bronchus significantly improved during the 2 years of bar placement.


CONCLUSIONS
A significant deformation of the airways was demonstrated in patients with pectus excavatum, which improved after correcting it by means of the Nuss procedure.
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. kamiyama@pedsurg.med.osaka-u.ac.jp
Masafumi
M
Kamiyama
Noriaki
N
Usui
Gakuto
G
Tani
Keisuke
K
Nose
Takuya
T
Kimura
Masahiro
M
Fukuzawa
D000402:Airway Obstruction / Q000209:etiology* / Q000503:physiopathology; D001980:Bronchi / Q000503:physiopathology*; D001999:Bronchoscopy; D002648:Child; D015331:Cohort Studies; D005660:Funnel Chest / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014132:Trachea / Q000503:physiopathology*; D016896:Treatment Outcome