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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 October;40(5):733-6

THORACIC PAPERS 

    ORIGINAL ARTICLES

Funnel ­chest. Psychological and psy­cho­so­mat­ic ­aspects in chil­dren, young­sters, and ­young ­adults

Ein­sie­del E., Claus­ner A.*

From the Kinderklinik d. Universität Mainz, Germany
*Kinderchirurgische Klinik d. Universität Mainz, Germany

Background. When con­sid­er­ing the indi­ca­tions for oper­a­tive cor­rec­tion of fun­nel ­chest, the ­first ques­tion is ­what is med­i­cal­ly actu­al­ly nec­es­sary, and ­what is found­ed sim­ply on ‘doc­tors ­opinion’. Furthermore symp­toms are ­often ­only indi­rect­ly cor­re­lat­ed ­with the ­basic ill­ness. This ­paper sug­gests a pos­sible way of objec­ti­vat­ing the symp­toms in 56 ­patients ­with fun­nel ­chest.
Methods. According to the ­results of our ret­ro­spec­tive exam­ina­tions the dif­fe­ren­ti­a­tion ­between ‘­physical’ and (mere­ly) ‘­cosmetic’ find­ings in the def­i­ni­tion of indi­ca­tions for oper­a­tion of fun­nel ­chests in chil­dren, young­sters and ­young ­adults, ­should be dis­pensed ­with. The symp­toms of “fun­nel ­chest” can be of var­ied sig­nif­i­cance, accord­ing to the ­degree of defor­mity, rang­ing ­from cos­met­ic ­fault to a ­severe hand­i­cap. Definition of indi­ca­tion ­thus ­depends in ­each ­case on all-inclu­sive ­plus dif­fe­ren­tial ­plus inter­lock­ing-system­ic diag­no­sis. In the ­course of ­this, not ­only somat­ic ­data, but ­also psy­cho­so­cial char­ac­ter­is­tics can be objec­ti­vat­ed and quan­ti­fied.
Results. The ­results of our exam­ina­tions ­show ­that the hand­i­caps of a fun­nel ­chest influ­ence all are­as of ­life. Older chil­dren (­over 11 ­years) dis­play as a ­whole ­more psy­cho­log­i­cal dis­or­ders. Along ­with spe­cif­ic emba­rass­ment reac­tions, ­social anx­ie­ty, feel­ings of stigma, lim­it­ed capac­ity for ­work, orien­ta­tion ­towards fail­ure, ­reduced tol­er­ance of frus­tra­tion and temp­ta­tion, lim­it­ed capac­ity for com­mu­ni­ca­tion and ­even mark­ed­ly depres­sive reac­tions are ­observed.
Conclusions. The under­ly­ing defor­mity and the psy­cho­log­i­cal reac­tions to it ­make a ­long-­term psy­cho­ther­a­py nec­es­sary. This may be ­laid out method­i­cal­ly ­more sim­ply and ­takes ­less ­time, ­when a per­ma­nent cor­rec­tion is ­brought ­about at oper­a­tion.

language: English


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