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November 15, 1958


JAMA. 1958;168(11):1550. doi:10.1001/jama.1958.03000110124013

References to funnel chest in the literature are increasing because of a change in attitude toward indications for operative treatment and some controversy regarding the best type of operation. This apparently hereditary anomaly results from a failure of normal development of the anterior portion of the diaphragm. Earlier writers considered attempting surgical correction only in patients who showed evidence of cardiorespiratory embarrassment, but with modern advances in chest surgery the indications have been greatly liberalized. Although improvement of the appearance of the chest may not be very important in itself, Sutherland1 called attention to the bad psychic effects in a child of having a deformity that is all too obvious in a gymnasium or natatorium. These children become shy, withdrawn, and depressed. The rapid improvement in personality after surgical correction is itself a sufficient justification of the procedure.

In addition to psychic symptoms funnel chest is associated with such postural