The vacuum bell is a natural, non-surgical method for correcting pectus excavatum (chest wall depression)
No specific laboratory tests are required for diagnosing pectus excavatum (PE) since the laboratory values in most children with chest deformity correspond to those of healthy children.
The diagnosis of PE is established based on radiological examinations, including chest X-rays and computed tomography (CT) scans of the chest, which are necessary for surgical correction.
X-Ray Examination Preoperative planning includes performing X-rays in both frontal and lateral projections. Surgeons use frontal X-rays to assess the degree of heart and mediastinal organ displacement and changes in the lungs. Lateral X-rays help determine the severity of the deformation by measuring the distance between the sternum and the spine. Additionally, routine chest X-rays can assess the presence of scoliosis, which is often found in patients with Pectus excavatum.
Conventional X-ray imaging does not allow for an evaluation of cartilage deformity features or the extent of dysplastic disorders.
Computed tomography (CT) is used by doctors to determine the Haller index, which is calculated by dividing the frontal diameter of the chest by the sagittal diameter. In normal cases, the Haller index (HI) is around 2.5. A HI ≥ 3.25 indicates a medical indication for surgical correction of pectus excavatum.
CT scans can assess the asymmetry of deformation, the degree of lung compression, and the extent of compression and displacement of the heart within the chest cavity, all of which need to be considered when planning surgical treatment. For better visualization of the chest organs, contrast-enhanced CT scans may be necessary during preoperative planning.
In addition to electrocardiography (ECG) for assessing heart function, echocardiography (EchoCG) is performed. This examination is not mandatory and is not conducted for those who do not have complaints related to the heart. However, for patients with Marfan syndrome, performing EchoCG and consulting a cardiologist is mandatory.
If necessary, patients with PE may undergo pulmonary function tests (spirometry) to assess lung function. Also, in the presence of accompanying conditions (Marfan syndrome, Ehlers-Danlos syndrome), consultations with a cardiologist, pulmonologist, and geneticist may be necessary.
Among the mandatory preoperative investigations are complete blood count, urine analysis, blood biochemical analysis, coagulogram, blood type determination, ECG, and X-ray examination.
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