Costal Cartilages Do Not Overgrow in Patients with Pectus Excavatum
Objective: The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects. Materials and Methods: The computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial...
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| Published in | Medical principles and practice Vol. 25; no. 6; pp. 533 - 538 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Basel, Switzerland
S. Karger AG
01.01.2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1011-7571 1423-0151 1423-0151 |
| DOI | 10.1159/000449133 |
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| Abstract | Objective: The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects. Materials and Methods: The computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial images the length of the 4th-7th costal cartilages was measured to calculate the Haller index. The ratio between the length of the cartilages and the median of the transverse and longitudinal thorax diameters were recorded to account for anatomical variability. The length of the cartilages was compared between the PE and control subjects using the independent-samples t test. For patients with asymmetric PE the length of the 4th-7th costal cartilages was compared between the rotated and nonrotated sides. Results: The mean transverse and coronal thorax diameters were 233.29 ± 24.47 and 231.69 ± 22.47 mm for PE patients and 252.67 ± 37.25 and 238.64 ± 27.40 mm for controls, respectively, with no significant differences between the two groups (p = 0.816 and 0.145). The mean sagittal diameter (59.30 ± 14.21 mm) and Haller index (4.02 ± 1.34) in the PE group were significantly different from the controls (107.34 ± 19.59 and 2.2 ± 0.54 mm, respectively; p = 0.00). Actual and relative lengths of costal cartilages were similar in both PE subjects and controls for all 4 costal cartilages measured. In subjects with asymmetric PE, both relative and absolute costal cartilage lengths were similar on the rotated and nonrotated side. Conclusions: The length of the 4th, 5th, 6th and 7th costal cartilages was similar in PE patients and the control subjects. These was also similar between the rotated and nonrotated sides of the sternum in patients with asymmetric PE. |
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| AbstractList | Objective: The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects. Materials and Methods: The computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial images the length of the 4th-7th costal cartilages was measured to calculate the Haller index. The ratio between the length of the cartilages and the median of the transverse and longitudinal thorax diameters were recorded to account for anatomical variability. The length of the cartilages was compared between the PE and control subjects using the independent-samples t test. For patients with asymmetric PE the length of the 4th-7th costal cartilages was compared between the rotated and nonrotated sides. Results: The mean transverse and coronal thorax diameters were 233.29 ± 24.47 and 231.69 ± 22.47 mm for PE patients and 252.67 ± 37.25 and 238.64 ± 27.40 mm for controls, respectively, with no significant differences between the two groups (p = 0.816 and 0.145). The mean sagittal diameter (59.30 ± 14.21 mm) and Haller index (4.02 ± 1.34) in the PE group were significantly different from the controls (107.34 ± 19.59 and 2.2 ± 0.54 mm, respectively; p = 0.00). Actual and relative lengths of costal cartilages were similar in both PE subjects and controls for all 4 costal cartilages measured. In subjects with asymmetric PE, both relative and absolute costal cartilage lengths were similar on the rotated and nonrotated side. Conclusions: The length of the 4th, 5th, 6th and 7th costal cartilages was similar in PE patients and the control subjects. These was also similar between the rotated and nonrotated sides of the sternum in patients with asymmetric PE. The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects.OBJECTIVEThe purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects.The computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial images the length of the 4th-7th costal cartilages was measured to calculate the Haller index. The ratio between the length of the cartilages and the median of the transverse and longitudinal thorax diameters were recorded to account for anatomical variability. The length of the cartilages was compared between the PE and control subjects using the independent-samples t test. For patients with asymmetric PE the length of the 4th-7th costal cartilages was compared between the rotated and nonrotated sides.MATERIALS AND METHODSThe computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial images the length of the 4th-7th costal cartilages was measured to calculate the Haller index. The ratio between the length of the cartilages and the median of the transverse and longitudinal thorax diameters were recorded to account for anatomical variability. The length of the cartilages was compared between the PE and control subjects using the independent-samples t test. For patients with asymmetric PE the length of the 4th-7th costal cartilages was compared between the rotated and nonrotated sides.The mean transverse and coronal thorax diameters were 233.29 ± 24.47 and 231.69 ± 22.47 mm for PE patients and 252.67 ± 37.25 and 238.64 ± 27.40 mm for controls, respectively, with no significant differences between the two groups (p = 0.816 and 0.145). The mean sagittal diameter (59.30 ± 14.21 mm) and Haller index (4.02 ± 1.34) in the PE group were significantly different from the controls (107.34 ± 19.59 and 2.2 ± 0.54 mm, respectively; p = 0.00). Actual and relative lengths of costal cartilages were similar in both PE subjects and controls for all 4 costal cartilages measured. In subjects with asymmetric PE, both relative and absolute costal cartilage lengths were similar on the rotated and nonrotated side.RESULTSThe mean transverse and coronal thorax diameters were 233.29 ± 24.47 and 231.69 ± 22.47 mm for PE patients and 252.67 ± 37.25 and 238.64 ± 27.40 mm for controls, respectively, with no significant differences between the two groups (p = 0.816 and 0.145). The mean sagittal diameter (59.30 ± 14.21 mm) and Haller index (4.02 ± 1.34) in the PE group were significantly different from the controls (107.34 ± 19.59 and 2.2 ± 0.54 mm, respectively; p = 0.00). Actual and relative lengths of costal cartilages were similar in both PE subjects and controls for all 4 costal cartilages measured. In subjects with asymmetric PE, both relative and absolute costal cartilage lengths were similar on the rotated and nonrotated side.The length of the 4th, 5th, 6th and 7th costal cartilages was similar in PE patients and the control subjects. These was also similar between the rotated and nonrotated sides of the sternum in patients with asymmetric PE.CONCLUSIONSThe length of the 4th, 5th, 6th and 7th costal cartilages was similar in PE patients and the control subjects. These was also similar between the rotated and nonrotated sides of the sternum in patients with asymmetric PE. The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects. The computed tomography acquisitions of 32 patients with PE and 35 normal controls were analyzed. On axial images the length of the 4th-7th costal cartilages was measured to calculate the Haller index. The ratio between the length of the cartilages and the median of the transverse and longitudinal thorax diameters were recorded to account for anatomical variability. The length of the cartilages was compared between the PE and control subjects using the independent-samples t test. For patients with asymmetric PE the length of the 4th-7th costal cartilages was compared between the rotated and nonrotated sides. The mean transverse and coronal thorax diameters were 233.29 ± 24.47 and 231.69 ± 22.47 mm for PE patients and 252.67 ± 37.25 and 238.64 ± 27.40 mm for controls, respectively, with no significant differences between the two groups (p = 0.816 and 0.145). The mean sagittal diameter (59.30 ± 14.21 mm) and Haller index (4.02 ± 1.34) in the PE group were significantly different from the controls (107.34 ± 19.59 and 2.2 ± 0.54 mm, respectively; p = 0.00). Actual and relative lengths of costal cartilages were similar in both PE subjects and controls for all 4 costal cartilages measured. In subjects with asymmetric PE, both relative and absolute costal cartilage lengths were similar on the rotated and nonrotated side. The length of the 4th, 5th, 6th and 7th costal cartilages was similar in PE patients and the control subjects. These was also similar between the rotated and nonrotated sides of the sternum in patients with asymmetric PE. |
| Author | Burlacu, Ovidiu David, Vlad-Laurentiu Cerbu, Simona Stanciulescu, Corina-Maria Boia, Eugen-Sorin Haragus, Horia Cozma, Gabriel Popoiu, Marius-Calin |
| AuthorAffiliation | b First Clinic of Orthopedics and Trauma, University of Medicine and Pharmacy, Timisoara, Romania c Department of Thoracic Surgery, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania a Department of Pediatric Surgery, University of Medicine and Pharmacy, Timisoara, Romania d Department of Imagistics, Emergency Children's Hospital ‘Louis Turcanu’, Timisoara, Romania |
| AuthorAffiliation_xml | – name: a Department of Pediatric Surgery, University of Medicine and Pharmacy, Timisoara, Romania – name: c Department of Thoracic Surgery, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, Romania – name: d Department of Imagistics, Emergency Children's Hospital ‘Louis Turcanu’, Timisoara, Romania – name: b First Clinic of Orthopedics and Trauma, University of Medicine and Pharmacy, Timisoara, Romania |
| Author_xml | – sequence: 1 givenname: Vlad-Laurentiu surname: David fullname: David, Vlad-Laurentiu – sequence: 2 givenname: Simona surname: Cerbu fullname: Cerbu, Simona – sequence: 3 givenname: Horia surname: Haragus fullname: Haragus, Horia – sequence: 4 givenname: Marius-Calin surname: Popoiu fullname: Popoiu, Marius-Calin – sequence: 5 givenname: Corina-Maria surname: Stanciulescu fullname: Stanciulescu, Corina-Maria – sequence: 6 givenname: Gabriel surname: Cozma fullname: Cozma, Gabriel – sequence: 7 givenname: Ovidiu surname: Burlacu fullname: Burlacu, Ovidiu – sequence: 8 givenname: Eugen-Sorin orcidid: 0000-0001-6379-1418 surname: Boia fullname: Boia, Eugen-Sorin email: chirpedmin@gmail.com |
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| Cites_doi | 10.1097/00000658-194406000-00012 10.1053/j.sempedsurg.2008.03.002 10.1053/j.semtcvs.2009.03.001 10.1016/j.jpedsurg.2010.04.018 10.1093/icvts/ivt401 10.1093/icvts/ivt392 10.1053/jpsu.2001.28820 10.1016/j.jpedsurg.2014.02.044 10.1093/icvts/ivt321 10.1016/j.jpedsurg.2008.09.023 |
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| Keywords | Costal cartilage Pectus excavatum Overgrowth Cartilage length |
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| References | Feng J, Hu T, Liu W, et al: The biomechanical, morphologic, and histochemical properties of the costal cartilages in children with pectus excavatum. J Pediatr Surg 2001;36:1770-1776.1173390410.1053/jpsu.2001.28820 Fokin AA, Steuerwald NM, Ahrens WA, et al: Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2009;21:44-57.1963256310.1053/j.semtcvs.2009.03.001 Nakaoka T, Uemura S, Yoshida T, et al: Overgrowth of costal cartilage is not the etiology of pectus excavatum. J Pediatr Surg 2010;45:2015-2018.2092072110.1016/j.jpedsurg.2010.04.018 Park CH, Kim TH, Haam SJ, et al: The etiology of pectus carinatum involves overgrowth of costal cartilage and undergrowth of ribs. J Pediatr Surg 2014;49:1252-1258.2509208510.1016/j.jpedsurg.2014.02.044 Sweet RH: Pectus excavatum. Ann Surg 1944;119:922-934.1785841910.1097/00000658-194406000-00012 Cubuk S, Yucel O: eComment: dilemma of the costal cartilage overgrowth in chest wall deformities. Interact Cardiovasc Thorac Surg 2013;17:763.2415004610.1093/icvts/ivt401 Kelly RE Jr: Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg 2008;17:181-193.1858282410.1053/j.sempedsurg.2008.03.002 Benhamed L, Hysi I, Wurtz AJ: eComment: is overgrowth of costal cartilages the unique cause of pectus deformities? Interact Cardiovasc Thorac Surg 2013;17:763.2415004510.1093/icvts/ivt392 Park CH, Kim TH, Haam SJ, et al: Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum. Interact Cardiovasc Thorac Surg 2013;17:757-763.2386860410.1093/icvts/ivt321 Nakaoka T, Uemura S, Yano T, et al: Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients. J Pediatr Surg 2009 ;44:1333-1336.1957365710.1016/j.jpedsurg.2008.09.023 ref8 ref7 ref9 ref4 ref3 ref6 ref5 ref10 ref2 ref1 19573657 - J Pediatr Surg. 2009 Jul;44(7):1333-6 25092085 - J Pediatr Surg. 2014 Aug;49(8):1252-8 17858419 - Ann Surg. 1944 Jun;119(6):922-34 11733904 - J Pediatr Surg. 2001 Dec;36(12):1770-6 18582824 - Semin Pediatr Surg. 2008 Aug;17(3):181-93 24150045 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):763 20920721 - J Pediatr Surg. 2010 Oct;45(10 ):2015-8 23868604 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):757-63 24150046 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):763 19632563 - Semin Thorac Cardiovasc Surg. 2009 Spring;21(1):44-57 |
| References_xml | – reference: Nakaoka T, Uemura S, Yano T, et al: Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients. J Pediatr Surg 2009 ;44:1333-1336.1957365710.1016/j.jpedsurg.2008.09.023 – reference: Sweet RH: Pectus excavatum. Ann Surg 1944;119:922-934.1785841910.1097/00000658-194406000-00012 – reference: Nakaoka T, Uemura S, Yoshida T, et al: Overgrowth of costal cartilage is not the etiology of pectus excavatum. J Pediatr Surg 2010;45:2015-2018.2092072110.1016/j.jpedsurg.2010.04.018 – reference: Park CH, Kim TH, Haam SJ, et al: The etiology of pectus carinatum involves overgrowth of costal cartilage and undergrowth of ribs. J Pediatr Surg 2014;49:1252-1258.2509208510.1016/j.jpedsurg.2014.02.044 – reference: Benhamed L, Hysi I, Wurtz AJ: eComment: is overgrowth of costal cartilages the unique cause of pectus deformities? Interact Cardiovasc Thorac Surg 2013;17:763.2415004510.1093/icvts/ivt392 – reference: Feng J, Hu T, Liu W, et al: The biomechanical, morphologic, and histochemical properties of the costal cartilages in children with pectus excavatum. J Pediatr Surg 2001;36:1770-1776.1173390410.1053/jpsu.2001.28820 – reference: Kelly RE Jr: Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg 2008;17:181-193.1858282410.1053/j.sempedsurg.2008.03.002 – reference: Cubuk S, Yucel O: eComment: dilemma of the costal cartilage overgrowth in chest wall deformities. Interact Cardiovasc Thorac Surg 2013;17:763.2415004610.1093/icvts/ivt401 – reference: Fokin AA, Steuerwald NM, Ahrens WA, et al: Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2009;21:44-57.1963256310.1053/j.semtcvs.2009.03.001 – reference: Park CH, Kim TH, Haam SJ, et al: Does overgrowth of costal cartilage cause pectus carinatum? A three-dimensional computed tomography evaluation of rib length and costal cartilage length in patients with asymmetric pectus carinatum. Interact Cardiovasc Thorac Surg 2013;17:757-763.2386860410.1093/icvts/ivt321 – ident: ref1 doi: 10.1097/00000658-194406000-00012 – ident: ref2 doi: 10.1053/j.sempedsurg.2008.03.002 – ident: ref3 doi: 10.1053/j.semtcvs.2009.03.001 – ident: ref5 doi: 10.1016/j.jpedsurg.2010.04.018 – ident: ref9 doi: 10.1093/icvts/ivt401 – ident: ref8 doi: 10.1093/icvts/ivt392 – ident: ref4 doi: 10.1053/jpsu.2001.28820 – ident: ref6 doi: 10.1016/j.jpedsurg.2014.02.044 – ident: ref7 doi: 10.1093/icvts/ivt321 – ident: ref10 doi: 10.1016/j.jpedsurg.2008.09.023 – reference: 20920721 - J Pediatr Surg. 2010 Oct;45(10 ):2015-8 – reference: 19573657 - J Pediatr Surg. 2009 Jul;44(7):1333-6 – reference: 24150046 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):763 – reference: 24150045 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):763 – reference: 11733904 - J Pediatr Surg. 2001 Dec;36(12):1770-6 – reference: 17858419 - Ann Surg. 1944 Jun;119(6):922-34 – reference: 23868604 - Interact Cardiovasc Thorac Surg. 2013 Nov;17 (5):757-63 – reference: 25092085 - J Pediatr Surg. 2014 Aug;49(8):1252-8 – reference: 18582824 - Semin Pediatr Surg. 2008 Aug;17(3):181-93 – reference: 19632563 - Semin Thorac Cardiovasc Surg. 2009 Spring;21(1):44-57 |
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| Snippet | Objective: The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal... The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal subjects.... The purpose of this study was to determine whether or not patients with pectus excavatum (PE) exhibit costal cartilage overgrowth compared to normal... |
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| SubjectTerms | Adolescent Adult Case-Control Studies Child Costal Cartilage - physiology Female Funnel Chest - diagnostic imaging Funnel Chest - physiopathology Humans Male Original Paper Tomography Scanners, X-Ray Computed Young Adult |
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| Title | Costal Cartilages Do Not Overgrow in Patients with Pectus Excavatum |
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