Sternal Cleft

Introduction

Sternal cleft is a rare congenital chest wall deformity. Based on the location and extent of the cleft, sternal cleft can be classified into 3 types: superior sternal cleft, inferior sternal cleft, and total sternal cleft. Isolated sternal cleft is uncommon, and in most cases, it is associated with other diseases, such as Pentalogy of Cantrell.

Causes

Sternal cleft is caused by the incomplete or partial fusion of the two sternal plates during embryonic development.

Symptoms

Common symptoms in patients with sternal cleft include abnormal breathing, cyanosis, breathing difficulty, and recurrent respiratory infections. When combined with Pentalogy of Cantrell, patients may also exhibit midline defect of the upper abdominal wall, pericardial defect adjacent to the diaphragm, and various types of cardiac malformation.

Diagnostic Methods

Diagnosis involves assessing the patient’s clinical manifestations and physical signs, as well as conducting imaging examinations such as chest CT scan and 3D reconstruction, and cardiac evaluations like echocardiography and angiography.

Treatment

Direct suturing:

This is suitable for patients with a small gap between the residual bones on both sides of the sternal cleft, where closure does not exert significant pressure on the mediastinal structures.

Chest wall reconstruction:

This involve reconstructing the sternal cleft using patients’s own ribs, followed by repairing the rib defect with MatrixRIBs. This surgical procedure is appropriate for patients with larger defect or rigid sternal cleft.