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Computed 3D Tomographic Analysis of the Nuss Procedure Using Pre- and Postoperative Utility

Murat Oncel¹, Guven Sadı Sunam¹, Seda Ozbek², Huseyın Yıldıran¹

¹Department of Thoracıc Surgery, Medıcal Faculty of Selcuk Unıversıty, Konya, Turkey

²Department of Radıodıagnostıc, Medıcal Faculty of Selcuk Unıversıty, Konya, Turkey


Aim: Standard modalities to assist in determining the extent of chest wall developmental deformities in patients include X-ray and computed tomography (CT). The purpose of this study is to describe an optical imaging technique that provides accurate cross-sectional images of the chest, and to compare pre-post-operative correction.

Material and methods: Thirty patients were included in this study. All patients were evaluated by 3D chest wall images created from computed thorax tomography preoperatively and postoperatively. All studies were performed in the supine position without the use of iodinated contrast material. Following data acquisition, multiplanar images as well as three-dimensional (3D) reconstructions were derived from 2D data, on the work station (Syngo.via, Siemens Healthcare, Forchheim, Germany). There were patients with sternal abnormalities such as abnormal segmentation and rotation.

Results:  Two patients were re-operated after Ravitch procedure and the 3D imaging of chest wall helped to us to see the costal cartilage defects. Twelve of all patients had sternal rotation and asymmetric depression. The postoperative 3D images showed the correction of the pectus deformity.

Conclusion: 3D tomographic analyze also allows exact pre-op measurement of the rib cage, lift the sternum and helps guide the operative correction. This data is useful in both preoparative and postoperative evaluation. is a useful objective means to follow the progress of patient growth progress, 3D tomographic analyze when used to evaluate children and young adults with congenital or acquired chest wall deformities, provides useful or critical information for surgical planning such as Sternal size, shape, and configuration may influence surgical planning. sternal length and rotation can be assessed to some degree by a careful preoperative physical examination, a bony sternal defect or an unfused sternum may not and might be too weak to support the pressure of a Nuss bar. These findings are clarified by 3D Computed Tomography and important for the surgeon's awareness.

Keywords: Computed thorax tomography, pectus excavatum, surgery