Usefulness of the evaluation of preoperative sternal shape for reconstruction of pectus excavatum using three-dimensional computed tomography

In the reconstruction of the pectus excavatum deformity, when sternal growth must be considered, it is desirable that osteotomy of the sternum be performed if necessary. From this standpoint, we evaluate the preoperative sternal shape using three-dimensional computed tomography. The sternum is outlined on the mid-sagittal plane, and the curved portions are examined. Preoperatively, the sternums are classified into 3 groups based on the number of curved portions. On the basis of these observations, we determine the position and degree of the sternal osteotomy and, if necessary, combined sternal osteotomy and augmentation using resected cartilage. We think that this method is useful not only for reconstruction of pectus excavatum but also in evaluating the postoperative shape of the thorax. (author)