The Institute of Chest Wall Surgery
GROOVED CHEST
Introduction
Causes
This deformity was often considered a type of pectus excavatum. However, due to its distinct characteristics and significant differences from pectus excavatum, the standard Nuss procedure is not suitable for correction. To facilitate its diagnosis and treatment, Dr. Wenlin Wang named it "Grooved Chest."
Grooved chest is characterized by a horizontal groove-like indentation in the lower chest wall. This indentation is relatively shallow, with no significant height difference between the bottom and the edges, unlike what is typically seen in pectus excavatum.
Symptoms
The formation of grooved chest may be related to calcium deficiency and is thought to be a result of the continued development of Harrison’s groove. However, its exact cause requires further research and validation.
Diagnostic Methods
Patients with mild grooved chest usually do not exhibit noticeable symptoms. However, those with severe grooved chest may experience chest tightness, shortness of breath, and breathing difficulty, and some may even develop digestive system symptoms. These symptoms can worsen after intense physical activity and may progressively deteriorate with age. Additionally, patients with grooved chest may develop scoliosis.
Diagnosis primarily involves a physical examination by observing the appearance of the chest wall, supplemented by imaging examination such as X-ray, chest CT scan and 3D reconstruction imaging.
Surgical Procedure
This is an improved version of the standard Wang procedure, tailored to the structural characteristics of grooved chest. Unlike pectus excavatum, grooved chest lacks the raised edges that provide stable fulcrums for the Nuss procedure. However, the Wang procedure, with its unique operating principles, is not constrained by this limitation. After optimizing the surgical techniques, the modified Wang procedure can be effectively applied to correct grooved chest.
A surgical approach refined from the standard Nuss procedure, which is applicable to the correction of various concave deformities. As grooved chest represents a rather unique concave deformity and lacks suitable fulcrums for performing the Wung procedure, special materials and operating techniques will be utilized during the operation to artificially create fulcrums, ensuring the smooth execution of the Wung procedure.
