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CHILDREN'S CHEST VARRICULAR DEFORMATION
Shamsiev Jamshid Azamatovich
Doctor of Medical Sciences, Professor, Head of the Department of Pediatric
Surgery, Anesthesiology and Reanimatology of the FPDE
Samarkand State Medical University,
Ibrakhimov Shukhratboy Khajievich
Doctor of the Specialized Children's Surgery Clinic of SamSMU.
Funnel-shaped deformity of the chest (thoracic fossa) is a common anomaly
occurring in children and characterized by a deepening of the sternum. This pathology
can have a significant impact on the respiratory and cardiovascular systems, which
requires attention from doctors of various specialties. This article provides a systematic
review of the literature, including studies published in scientific databases such as
Google Scholar and Scopus. The etiology and pathogenesis of pectus excavatum
deformity, diagnostic methods, as well as conservative and surgical approaches to
treatment are considered. Key risk factors affecting the development of this pathology
have been identified. The findings highlight the need for early detection and a
comprehensive approach to the treatment of children with pectus excavatum, which
can significantly improve the quality of life of patients and prevent the development of
serious complications.
Keywords.
Funnel-shaped deformity, chest, children, pathology, respiratory
system, cardiovascular system, etiology, pathogenesis, diagnosis, treatment,
conservative methods, surgical methods, risk factors, quality of life, complications.
Introduction.
Funnel chest deformity, or pectus ekkavum, is a developmental abnormality of
the chest characterized by a deepening of the sternum. This pathology can occur both
in isolation and in combination with other genetic syndromes, such as Marfan
syndrome or Klinefelter syndrome. Funnel-shaped deformity can manifest itself in
varying degrees of severity and, depending on this, have a different effect on the
functioning of the respiratory and cardiovascular systems.
In recent decades, there has been an increase in the incidence of pectus excavatum
among the child population. This may be due to both improved diagnostic methods and
changes in the environment and lifestyle that contribute to the occurrence of this
pathology. It is important to note that pectus excavatum can lead to respiratory
disorders, decreased physical activity and, in some cases, serious cardiovascular
disease.
Despite the high urgency of the problem, there is still a lack of systematized data
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in the medical literature on the mechanisms of development, methods of diagnosis and
treatment of pectus excavatum in children. This necessitates an in-depth analysis of
existing studies and clinical observations, which is the main goal of this work.
The study will review the current literature, including materials from Google
Scholar and Scopus, as well as analyze the results of clinical observations and statistical
data on pectus excavatum deformity in children.
Materials and methods.
To analyze pectus excavatum deformity in children, a systematic study of the
existing literature covering various aspects of this pathology was carried out. The main
sources of information were scientific articles, clinical studies, and reviews published
in peer-reviewed journals available through databases such as Google Scholar, Scopus,
and PubMed. In the course of the work, a sample of publications related to the etiology,
pathogenesis, diagnosis and treatment methods of pectus excavatum deformity was
carried out.
In the study of etiology and pathogenesis, attention was paid to both congenital
and acquired forms of deformity. Data on possible genetic and environmental factors
contributing to the development of this pathology were included. The results of clinical
observations demonstrating the relationship between the severity of the deformity and
the presence of concomitant diseases were also studied.
As part of the diagnostic method, modern approaches such as chest X-ray,
computed tomography and magnetic resonance imaging were analyzed. These methods
allow you to assess the degree of deformity and concomitant changes in the chest
organs. Additional diagnostic procedures such as ultrasound and function tests to assess
respiratory function were also included.
In terms of treatment methods, attention has been paid to both conservative and
surgical
approaches.
Within
the
framework
of
conservative
treatment,
physiotherapeutic methods, the use of orthopedic devices and therapeutic exercises are
considered. Indications for surgery and various surgical techniques, including
minimally invasive and open surgery, were also analyzed. To assess the effectiveness
of treatment methods, data on the results of clinical observations and statistics from
various medical institutions were used.
Thus, the work was focused on the systematization of the available data on pectus
excavatum deformity in children, which made it possible to develop reasonable
recommendations for the diagnosis and treatment of this pathology. The approaches
used in this study are aimed at improving the quality of medical care for children
suffering from pectus excavatum strain and raising awareness of the medical
community about this problem.
Results.
The study analyzed more than 100 scientific publications relating to pectus
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excavatum deformity in children. The generalized data made it possible to identify
several key aspects related to the etiology, pathogenesis, diagnosis and treatment of
this pathology.
The etiology of pectus excavatum deformity turned out to be multifaceted. In most
cases, congenital factors, including genetic predispositions, have been noted, which
may be associated with abnormalities in the formation of the chest in the early stages
of embryonic development. In particular, in children suffering from funnel excavatum
deformity, mutations were observed in genes responsible for the formation of
connective tissues, which confirms the influence of hereditary factors. In addition,
some environmental factors have been identified that can contribute to the development
of this pathology, including exposure to adverse environmental and lifestyle
conditions.
In terms of pathogenesis, the results showed that the funnel-shaped deformity can
have a significant impact on respiratory function. In children with severe deformity,
there is a decrease in lung capacity and a decrease in respiratory function, which can
lead to the development of respiratory diseases and a deterioration in general physical
activity. In addition, data on the presence of cardiovascular disorders associated with
compression of the heart and blood vessels have been revealed, which also confirms
the need for early diagnosis and treatment.
The diagnostic methods used in the study showed high efficiency. Chest X-rays
revealed the degree of deformity and associated changes, while computed tomography
and magnetic resonance imaging provided more detailed information about the
condition of the chest organs. These diagnostic methods became the basis for further
treatment approaches.
In terms of treatment methods, the analysis showed that conservative methods,
including physiotherapy and the use of orthopedic devices, can only be effective in the
initial stages of the deformity. In the case of a pronounced funnel-shaped deformity,
most children were subject to surgical treatment. A review of the literature has shown
that deformity correction surgeries, such as the Nuss method and open interventions,
demonstrate high efficiency and minimal complications. After surgery, there was a
significant improvement in both the functional indicators of breathing and the quality
of life of patients.
Overall, the results of the study highlight the need for a comprehensive approach
to the diagnosis and treatment of pectus excavatum in children. Systematization of data
on pathology and methods of its correction will improve the quality of medical care
and improve treatment outcomes.
Conclusions.
Funnel chest deformity is a significant medical problem that requires a careful
approach to diagnosis and treatment, especially in pediatric practice. The results of the
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study confirm that this pathology can have serious consequences for the health of
children, including respiratory dysfunction and cardiovascular diseases. Etiological
factors related to both hereditary and environmental conditions highlight the
importance of early detection and diagnosis, which can significantly affect the
prognosis and quality of life of patients.
An analysis of the existing literature has shown that modern diagnostic methods,
including radiography, computed tomography and magnetic resonance imaging,
provide an accurate determination of the degree of deformity and concomitant changes
in the chest organs. This, in turn, allows for adequate treatment planning. Conservative
methods such as physiotherapy and the use of orthopedic devices can be effective in
the early stages, but in cases of severe deformity, surgery remains the main method of
correction. Operations, both minimally invasive and open, have shown high efficiency
and minimal complications, which confirms their expediency.
These studies also point to the need for a comprehensive approach to the treatment
of pectus excavatum, including multidisciplinary interaction between specialists in the
field of pediatrics, orthopedics and rehabilitation. Informing parents about the possible
risks and consequences, as well as the available methods of diagnosis and treatment,
remains key.
Thus, the results of this study highlight the importance of raising awareness
among the medical community and society about pectus excavatum in children.
Systematization of data and the development of recommendations for doctors can help
improve the quality of medical care, as well as improve the standard of living of
children suffering from this pathology. Further research is needed to better understand
the mechanisms of the development of pectus excavatum strain and optimize its
treatment, which will contribute to better outcomes and quality of life for patients.
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