Document Detail


Phenotypic spectrum and management of sternal cleft: literature review and presentation of a new series.
MedLine Citation:
PMID:  21737294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sternal cleft is a chest wall malformation that can expose mediastinal viscera and vessels to injuries. It can be classified into two forms, complete and partial. Its etiology and incidence are unknown and it is often associated with other defects. The aim of this article is to review the literature and report our experience with this rare anomaly, focusing on clinical presentation and management. We reviewed the English written literature about sternal cleft and collected the clinical data of all the published series. We present seven new cases that we have observed and treated since 1999. Literature reports 51 series including 86 patients, more frequently female (62%) and affected with partial superior form (67%). Sternal cleft is often asymptomatic (74%) and associated with other defects (72%). Surgical treatments include primary closure (73%), bone graft interposition (10%), prosthetic closure (7%), and muscle flap interposition (3%). In our series, primary closure was possible in four cases, while in three cases we placed a prosthesis. Five patients had associated defects and two were affected with PHACES (posterior fossa abnormalities, hemangiomas, arterial lesions, cardiac abnormalities/aortic coarctation, abnormalities of the eye, and sternum defects) syndrome. We report for the first time the association of sternal cleft with connectival nevi in three of our patients. At follow-up, we observed no major complication or recurrences. Although primary closure is the preferred option and should be performed in the neonatal period, the use of prostheses warrants good results as well. Prior to treatment, associated defects and syndromes should be excluded.
Authors:
Michele Torre; Giovanni Rapuzzi; Marcello Carlucci; Luca Pio; Vincenzo Jasonni
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  41     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-03-01     Completed Date:  2012-05-01     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  4-9     Citation Subset:  IM    
Affiliation:
Pediatric Surgery, Giannina Gaslini Children's Hospital, and University of Genoa, Genoa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / surgery
Bone Transplantation / methods
Child
Child, Preschool
Facial Neoplasms / diagnosis
Female
Hemangioma / diagnosis
Humans
Infant
Infant, Newborn
Male
Musculoskeletal Abnormalities / radiography,  surgery*
Phenotype
Prostheses and Implants
Reconstructive Surgical Procedures / methods
Retrospective Studies
Sternum / abnormalities,  radiography,  surgery
Surgical Flaps
Tomography, X-Ray Computed
Treatment Outcome
Comments/Corrections

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