Chest Wall Deformity Center
Offering comprehensive and personalized care for the treatment of chest wall deformities
WakeMed Children’s is pleased to offer a comprehensive and personalized care model designed to simplify the diagnosis, evaluation, and treatment of chest wall deformities such as Pectus Excavatum, Congenital Rib Anomalies, Acquired Jeune’s Syndrome, Slipping Rib Syndrome, Pectus Carinatum, Poland’s Syndrome and Gynecomastia.
Chest Wall Deformities and Treatment
WakeMed’s pediatric surgeons work closely with parents and children to explain the various chest wall deformities, treatment options and what to expect throughout the patient’s entire treatment journey.
Our surgeons carefully review each case prior to the first appointment to assess what consultative services and testing may be necessary prior to surgery. We then work carefully with our team to schedule all diagnostic tests and consultations for the same day whenever possible – helping to facilitate a streamlined path to surgery, which is particularly helpful for our patients who travel to us from throughout the region.
We offer a comprehensive array of treatment options including:
Nuss Procedure: The Nuss procedure is a minimally invasive technique for patients with pectus excavatum and involves hardware that can help reshape the chest wall over time.
External Bracing: Many patients with pectus carinatum benefit from using a non-invasive external brace that gradually moves the sternum into the appropriate position over time.
Ravitch Procedure: This surgical treatment option is indicated for patients with both pectus excavatum and pectus carinatum. The procedure involves the repair/ reshaping of the sternum.
Recurrent Chest Wall Problems: Many of our patients have had previous chest wall reconstruction procedures without success. We work with patients and families to determine the most effective course of treatment for those who may need revisional procedures or ongoing care for post-operative complications.
A major concern for children and young adults undergoing chest wall surgery is adequate relief of perioperative pain. We have found that there is no "one size fits all" approach and that pain relief strategies may involve a combination of modalities, depending upon the particular patient, his/her age, and chest configuration. We have successfully used intravenous narcotics and non-steroidal anti-inflammatory medications, long-acting oral medications, epidural anesthesia, multi-level intercostal nerve block catheters, and/or cryo-analgesia (temporarily "freezing" chest wall nerves). We encourage patients and their families to discuss these issues in detail with our team prior to any surgical procedure.
As the busiest treatment center for chest wall deformities in North and South Carolina, WakeMed and its team of pediatric surgeons and partnering specialists provide the most advanced treatments available – treating everything from the most common conditions to the most complex problems. When it comes to caring for kids, no one has more experience than WakeMed Children’s.
Team Approach and Convenience
Our coordinated team works collaboratively to evaluate patients who have been diagnosed with chest wall deformities. Our team approach combines many disciplines to provide the most comprehensive evaluation and treatment – all in one convenient location. Our team and partnering specialists include:
- Pediatric Surgery
- Pediatric Radiology
- Pediatric Anesthesiology
- Plastic Surgery
- Pediatric Physical Therapy
- Pediatric Intensive Care
- Pediatric Cardiology
- Pediatric Pulmonology
- Pediatric Orthopaedics
David Hoover MD, FACS, FAAP
J. Duncan Phillips MD, FACS, FAAP