The effect of pectus excavatum deformity on lung volume: fact or myth?
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ORIGINAL ARTICLE
The effect of pectus excavatum deformity on lung volume: fact or myth? Hakan Cebeci1 · Abidin Kılınçer1 · Mustafa Yasir Özlü1 · Mehmet Öztürk1 · Murat Öncel2 · Güven Sadi Sunam2 Received: 25 February 2020 / Accepted: 29 May 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Background and purpose Most of the previous studies evaluating lung volume of pectus excavatum (PE) patients were based on spirometric measurements. We aimed to calculate lung volume of patients with PE and compare them with lung volume of patients without chest wall deformity using CT volumetry. Methods After institutional review board approval, preoperative chest CT of PE patients who underwent minimal invasive procedure between January 2012 and February 2018, were evaluated retrospectively. As a control group, age and sex matched patients who underwent chest CT scan in the same period were enrolled. Total, right and left lung volumes were calculated using an automated software. Haller indexes were measured for both groups. Lung volumes and Haller indexes compared between the two groups. We also compared left and right lung volumes in both groups. We evaluated whether there is a correlation across the Haller index and total lung volume. Results Total, right and left lung volumes were not statistically different between the two groups. While left lung volumes were significantly smaller in PE group (p = 0.041), there was no significant difference between the left and right lung volume in the control group (p = 0.12). Haller index and total lung volume showed no significant correlation between patients with the same age and gender (p = 0.14, R = −0.3). Conclusions PE deformity does not reduce lung volume when compared to age and sex matched control group. Quantitative CT volumetric evaluation of lung gives valuable data about lung volume. Keywords Pectus excavatum · Lung volume · CT · Lung CT volumetry · Haller index
Introduction Pectus excavatum (PE), is the most common congenital chest wall anomaly in children. Incidence of PE is reported 1/400 live births [9] It is characterized by a posterior depression of the sternum and costal cartilages. PE is seen more often in European population and males. The asymmetric form is the most common, and the right side is generally more depressed, sometimes with sternal rotation. PE usually becomes more prominent during the growth spurt, but in some cases, it becomes less severe. PE is commonly a * Abidin Kılınçer [email protected] 1
Department of Radiology, Faculty of Medicine, Selçuk University, 42130 Konya, Turkey
Department of Thoracic Surgery, Faculty of Medicine, Selçuk University, Konya, Turkey
2
cosmetic and psychosocial problem with no clinical symptoms. However, some PE patients suffer from exercise intolerance, chest pain and shortness of breath [4, 7]. Chest wall anomaly and sternal depression can cause cardiopulmonary problems both at rest and during exercise, particularly when the depression is severe [5]. It is generally bel
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