Titanium plating system with autologous rib graft sternoplasty in the treatment of thoracic inlet compression

Matthew Alexander; John Keech; Peter J Gruber; Donald Dean Potter

doi:10.1016/j.epsc.2015.11.011

Back

Titanium plating system with autologous rib graft sternoplasty in the treatment of thoracic inlet compression

Journal article

Open access

Peer reviewed

Titanium plating system with autologous rib graft sternoplasty in the treatment of thoracic inlet compression

Matthew Alexander, John Keech, Peter J Gruber and Donald Dean Potter

Journal of pediatric surgery case reports, Vol.4(C), pp.27-31

01/2016

DOI: 10.1016/j.epsc.2015.11.011

Files and links (1)

url

https://doi.org/10.1016/j.epsc.2015.11.011View

Published (Version of record) Open Access

Abstract

Narrowing of the thoracic inlet leading to airway compression is a rare and challenging condition in the pediatric population. Reports in the literature have described this variant related to multiple conditions including double crush phenomenon following repair of pectus excavatum, anterior spinal displacement, and straight back syndrome. Underlying genetic conditions such as Marfan's Syndrome and Hurler's Syndrome have also been reported to contribute to clinically significant airway compression independent of dynamic tracheal collapse such as tracheomalacia. The borders of the thoracic inlet are anatomically bound by the body of the first thoracic vertebrae (T1) posteriorly, the posterior surface of the manubrium anteriorly, and the medial aspects of the first ribs on either side laterally. Relief of tracheal compression in this location is complicated by the rigidity of the boney thoracic inlet and limited space for lifting procedures such as anterior aortopexy. Several operative approaches to treat this condition have been described including manubrial/sternal resection, first rib resection, and reconstruction of the thoracic inlet. Described here are three patients where successful reconstruction of the thoracic inlet was achieved using autologous rib graft sternoplasty and a titanium sternal plating system to widen the thoracic inlet and eliminate external compression on the trachea.

Sternoplasty

Straight back syndrome

Tracheal compression

Titanium plating

Aortopexy

Details

Title: Subtitle: Titanium plating system with autologous rib graft sternoplasty in the treatment of thoracic inlet compression
Creators: Matthew Alexander - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
John Keech - Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Peter J Gruber - Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Donald Dean Potter - Division of Pediatric Surgery, Mayo Clinic, 200 First Street SW, Rochester 55905, MN, USA
Resource Type: Journal article
Publication Details: Journal of pediatric surgery case reports, Vol.4(C), pp.27-31
DOI: 10.1016/j.epsc.2015.11.011
ISSN: 2213-5766
eISSN: 2213-5766
Publisher: Elsevier Inc
Language: English
Date published: 01/2016
Academic Unit: Surgery; Cardiothoracic Surgery
Record Identifier: 9984051537902771

Metrics

27 Record Views