Self-Esteem Jumps After Chest-Abnormality Surgery

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Children with a congenital chest deformity called pectus excavatum, or funnel chest, are routinely self-conscious and ill at ease in the extreme. But after they undergo surgery to correct the defect, their self-concept and social lives improve dramatically. "These results should prompt physicians to consider the physiologic and psychological implications of pectus excavatum just as they would any other physical deformity known to have such consequences," said Robert E. Kelly, of Eastern Virginia Medical School, in Norfolk, Va., and his colleagues in the journal Pediatrics.

In pectus excavatum, the connective tissue that joins the ribs to the breastbone is overgrown, causing the sternum to curve inward. This gives the chest a hollow appearance. The researchers say the disorder is often belittled as "only cosmetic," but note that it "is not trivial in its effects on the life of the child."

The researchers had 264 funnel chest sufferers complete the Pectus Excavatus Evaluation Questionnaire, which asks patients how the disorder affects their physical, mental and social lives. These people, ranging in age from eight to 21, then underwent corrective surgery. A year later, a follow-up survey was done by 247 patients and 274 of their parents.

The survey-takers answered questions on a scale of 1 to 4, with 4 indicating the worst possible experience. The study reported that 97 percent of patients felt their chests looked better following surgery. The procedure also boosted their body image and diminished their feelings of social self-consciousness.

On the scale of 1 to 4, postsurgical body-image scores strengthened, moving from 2.30 to 1.40. The physical difficulty associated with patients' condition improved from 2.11 to 1.37. Parents' responses also showed that their children's emotional difficulties, social self-consciousness and physical problems had improved, moving respectively from 1.81 to 1.24, 2.86 to 1.33, and 2.14 to 1.32.

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