What is Platythorax (Anteroposterior Flattening)?
Although there are many classification types that have been created in accordance with the morphological features of pectus deformities, the classification recommended by Willital et al. [*] is the one that is accepted the most in clinical use (Figure 1).
*Willital GH, Saxena AK, Schütze U, Richter W. Chest- deformities: a proposal for a classification. World J Pediatr 2011;7:118-23.
As can be seen in this classification, apart from the usual deep pectus excavatum deformities such as type 1 or 2, there are also deformities such as type 3 or type 4, in which the anterior wall of the chest collapses inward in a widespread manner without any obvious point-focused collapse. These cases are called platythorax.
Platythorax cases, just like type 1 and 2 pectus excavatum Deformities, can be treated non-surgically with Vacuum Bell or surgically with Nuss Procedure. Depending on the expectations of the patient and his/her family, it is decided together with the doctor which treatment is best for which patient.
Since the pressure on the thorax is more common in Platythorax cases, the heart, lungs, esophagus, stomach and large vessels are under pressure. Especially the collapse in the upper part of the sternum bone near the neck puts pressure on the large vessels. Since these vessels are the main outlets that feed the entire body, they can lead to many circulatory problems in the long term, such as dementia, male sexual dysfunction, and miscarriage in women.
In Figure 2-3-4-5, I am sharing with you the pre-operative and 3-year post-bar removal chest images and images of the heart-sternum relationship on the X-ray of a 16-year-old male patient for whom I have performed Nuss surgery due to platythorax…