PHOENIX, Ariz. (Ivanhoe Newswire) — Pectus excavatum or “funnel chest” happens when a child grows quickly and the chest bones don’t develop correctly, often causing a sunken or hollow-looking chest. Corrective surgery is now minimally invasive, but it’s still incredibly painful for a long time. Now surgeons at Phoenix Children’s Hospital are using cryoablation to ease that pain.
Sebastian Diaz ran track and noticed his running performance deteriorating in the summer of 2017.
Diaz said, “It was a lot of shortness of breath, rapid heart rate, just really felt like I was kind of like trapped. I couldn’t reach my full potential in the sport and stuff.”
He and his family decided he needed to get his pectus excavatum fixed.
Dan Ostlie, MD, Surgeon-in-Chief at Phoenix Children’s Hospital wanted to use cryoablation before inserting a rod into the chest to push it out. He holds a probe that’s minus 60 degrees Celsius to four layers of nerves for two minutes. Diaz was patient number one.
Dr. Ostlie said, “That causes the child to become numb across the front of the chest while the bar is in place and decreases the amount of pain they have associated with the repair.”
The numbness lasts for two months or more, meaning fewer painkillers for less time.
David Notrica, Co-Director, Chest Wall Program at Phoenix Children’s Hospital said, “We now have kids that are coming off the pain medication at less than two weeks; whereas before, it was a month to get them off the oxycodone.”
Diaz says his recovery has been easy, and he feels better than ever: “There was a 100 percent difference in terms of my performance, everything I did. It was really exciting.”
Also exciting: he heads to college this fall, as a pre-med student.
Dr. Ostlie will remove the rod from Diaz’s chest at the three-year mark, in about 18 months. Surgeons at Phoenix Children’s started using cryo before pectus repair 18 months ago. They have successfully treated 95 patients who’ve all regained full feeling in their frozen nerves.
Contributors to this news report include: Wendy Chioji, Field Producer; Bruce Maniscalco, Videographer; Cyndy McGrath, Supervising Producer; Roque Correa, Editor.
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TOPIC: FREEZING AWAY THE PAIN FROM FUNNEL CHEST
REPORT: MB #4626
BACKGROUND: Pectus excavatum (PE) and pectus carinatum (PC) are the two most common types of chest wall deformities. PE causes the rib cage to sink and have a caved in appearance and is known as funnel chest. PC causes the rib cage to push itself outward and also known as pigeon breast. PE affects one in 400 children and is most common in males and up to 40 percent of patients will have a family member who has also had it, but there is no clear genetic link. PC is a little less common, only one fifth as many children get it compared to PE. It appears later in life than PE with 50 percent being diagnosed at 11 years of age.
SYMPTOMS: Symptoms for PE include sunken appearance in the chest, shortness of breath, and decreased stamina during exercise. It can also cause chest pain form cartilage and bone growth growing at an abnormal rate. It gets worse with age and especially during growth spurts for children. PC symptoms include the chest wall protruding forward, the chest wall having one side protruding forward and the other sinking in, possible cardiopulmonary issues, and chest pain.
CRYOABLATION: Dan Ostlie, MD, Surgeon-in-Chief at Phoenix Children’s Hospital explains how cryoablation is making chest reconstruction less pain for children. “Cryoablation is where we take a probe and we freeze the intercostal nerves. The intercostal nerves are the nerves that run underneath your ribs and give you sensation across the front of your chest. So we use a probe that freezes those nerves at minus 60 degrees centigrade for about two minutes,” said Ostile. The surgery involves putting a bar behind the chest which only takes about 20 seconds to straighten the chest, which is why it is a painful procedure. Ostile says that the cryoablation “causes the child to be numb across the front of their chest while the bar is in place initially and decreases the amount of pain they have associated with the repair.”
(Source: Dan Ostile, MD)
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