title: Pectus excavatum: history, hypotheses and treatment options.
abstract: Pectus excavatum and pectus carinatum represent the most frequent chest wall deformations. However, the pathogenesis is still poorly understood and research results remain inconsistent. To focus on the recent state of knowledge, we summarize and critically discuss the pathological concepts based on the history of these entities, beginning with the first description in the sixteenth century. Based on the early clinical descriptions, we review and discuss the different pathogenetic hypotheses. To open new perspectives for the potential pathomechanisms, the embryonic and foetal development of the ribs and the sternum is highlighted following the understanding that the origin of these deformities is given by the disruption in the maturation of the parasternal region. In the second, different therapeutical techniques are highlighted and based on the pathogenetic hypotheses and the embryological knowledge potential new biomaterial-based perspectives with interesting insights for tissue engineering-based treatment options are presented.
authors.affiliation: REPAIRlab, Institute of Pathology, University Medical Centre Mainz, Mainz, Germany. brochhausen@pathologie.klinik.uni-mainz.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Brochhausen
authors.forename: Salmai
authors.initials: S
authors.lastname: Turial
authors.forename: Felix K P
authors.initials: FK
authors.lastname: Müller
authors.forename: Volker H
authors.initials: VH
authors.lastname: Schmitt
authors.forename: Wiltrud
authors.initials: W
authors.lastname: Coerdt
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Wihlm
authors.forename: Felix
authors.initials: F
authors.lastname: Schier
authors.forename: C James
authors.initials: CJ
authors.lastname: Kirkpatrick
mesh_terms: D005660:Funnel Chest / Q000453:epidemiology / Q000266:history / Q000503:physiopathology / Q000601:surgery; D049669:History, 16th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D013249:Sternum / Q000002:abnormalities* / Q000601:surgery; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome