Description of a novel chest wall anomaly: The postprematurity thoracic dysplasia

J Pediatr Surg. 2021 Apr;56(4):700-705. doi: 10.1016/j.jpedsurg.2020.06.008. Epub 2020 Jun 13.

Abstract

Background/purpose: Many studies on ex-preterm babies were conducted to evaluate their respiratory sequelae, but, to our knowledge, the condition described in this paper was never reported before and is not included in the classifications of thoracic anomalies proposed so far.

Methods: Clinical data and images of a novel thoracic deformity observed in the last 10 years are shown. This anomaly is characterized by an indentation of the ribs on both (less frequently one) anterolateral parts of the chest wall. All our patients with this condition were ex-preterm babies. We named this novel thoracic anomaly as "postprematurity thoracic dysplasia" (PPTD). Possible etiopathogenetic mechanisms and treatment options are discussed.

Results: We observed 8 patients with variable range of respiratory symptoms. In 2 cases the malformation caused a severe functional restriction of lung volumes and surgery was performed to improve respiratory symptoms; in other cases the symptoms were mild or absent and the malformation was a matter of concern only for cosmesis.

Conclusions: PPTD is a novel thoracic anomaly typical of ex-preterms. Clinical relevance is variable. In severe cases surgery can be considered.

Level of evidence: IV.

Keywords: Chest wall anomaly; Classification of thoracic deformities; Prematurity; Rib; Thoracic malformation; Thoracoplasty.

MeSH terms

  • Humans
  • Infant, Newborn
  • Lung Volume Measurements
  • Ribs
  • Thoracic Wall*