SPIRAL CT WITH 3D RECONSTRUCTION IN CHILDREN REQUIRING REOPERATION FOR FAILURE OF CHEST-WALL GROWTH AFTER PECTUS EXCAVATUM SURGERY - PRELIMINARY-OBSERVATIONS

Pectus excavatum is the most common congenital chest wall deformity. E xtensive corrective surgery prior to age 3 may disturb chest wall grow th and result in a constricted thorax. We describe our surgical and ra diologic experience with eight such cases, paying particular attention to the role of spiral computed tomography (CT) with 3D reconstruction in patient management. Spiral CT was performed on children who had de veloped restrictive chest walls following pectus excavatum surgery, Th ese children then underwent a unique operation to elevate the sternum and attempt to correct their restrictive chest wall defects. In severa l cases, postoperative spiral CT was performed. Spiral CT with 30 reco nstruction defined the orientation of the ribs and costal cartilages a nd their relationship to the sternum, allowing exact preoperative meas urement of the bony rib cage and guiding individualized operative corr ection. Computed thoracic volumes in select cases correlated well with subjective patient reports of increased exercise capacity. Repair of pectus excavatum defects prior to age 3 may result in constrictive tho racic abnormalities. Surgical correction can increase thoracic volume and improve prospects for normal thoracic function. Three-dimensional reconstruction of spiral CT data is useful in both preoperative and po stoperative evaluation. (C) Elsevier Science Inc., 1998.