Sternal Cleft: Appropriate Approach to Diagnosis and Treatment
Journal Title: Surgery & Case Studies: Open Access Journal - Year 2018, Vol 1, Issue 3
Abstract
Sternal cleft (SC) is a rare congenital anomaly of the chest wall, isolated or combined with other malformations. We try to provide an appropriate stepwise approach for the diagnosis and treatment of SC. Prenatal ultrasound diagnosis can be obtained after the 18th week of gestation. At birth, diagnosis is based on the findings of clinical examination, chest x-ray, computed tomography and additional investigations for the associated anomalies. Primary approximation of the sternal bars is preferred before the age of 3 months. For older cases and rigid chest wall, the surgical correction can be achieved using prosthetic materials, autologous grafts, or biologic implants. The surgical decision depends on the age of patient, rigidity of the chest wall, and presence of other abnormalities in the chest wall. Normally, the sternum is developed by fusion of two mesenchymal bars, between the 7th and 10th week of gestation, extending from the manubrium to the xiphoid process [1]. Sternal cleft (SC) is a rare chest wall anomaly occurs after failure of the sternal bars to fuse. It accounts for 0.15% of chest wall malformations, and occurs in less than 1:100,000 of live births, with a female predominance [2]. The SC may be partial or total depending on its extension. In regard to its location, the defect may be superior, inferior or complete. Other malformations may occur with SC, like hemangiomas, omphalocele, pentalogy of Cantrell (Ectopia cordis, intracardiac defects, sternal cleft, omphalocele, pericardial defect), PHACES syndrome (posterior fossa brain malformations, facial hemangiomas, arterial anomalies, cardiac defects, eye abnormalities, sternal cleft and supra-umbilical raphe), gastroschisis, pectus excavatum, and hamartoma [1,3].
Authors and Affiliations
Yasser Ali Kamal
Keywords
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- EP ID EP637659
- DOI 10.32474/SCSOAJ.2018.01.000112
- Views 109
- Downloads 0
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