Prospective evaluation and successful outcomes using vacuum bell therapy for pectus excavatum in selected pediatric patients: analysis of a prospective cohort study of 240 patients
AlShammari, Abdullah Santhirakumaran, Gowthanan Patel, Akshay Hunt, Ian
AlShammari, Abdullah
Santhirakumaran, Gowthanan
Patel, Akshay
Hunt, Ian
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Publication date
2025-11-04
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Abstract
Background: Pectus excavatum (PE) is relatively a common congenital chest wall deformity that can cause both functional and psychological impairments. Vacuum bell therapy (VBT) is a nonsurgical treatment modality used to correct sternal depression in growing children and adolescents.
Methods: This prospective cohort study assessed the effectiveness of VBT in 240 paediatric patients over an 18- to 24-month period. Baseline data including demographics, clinical and morphological severities were longitudinally assessed over a period of 18 to 24 months. Only patients whose initial assessment showed evidence of sternal elevation on application of VBT were included. Funnel depth, chest pain, and breathing difficulty scores were assessed before and after VBT application. Although not presented as part of this study, the presence of postural related issues also was recorded and subsequently assessed in response to targeted physical therapy.
Results: The mean baseline funnel depth was 21.11 mm, which decreased significantly to 7.7 mm following therapy (P < .001). On a 10-point scale, breathing difficulty scores improved from a mean of 3.58 to 2.0 (P < .001), while chest pain scores showed no significant change. On a 10-point scale with higher scores indicating higher satisfaction, patient satisfaction was significantly higher post-VBT compared to pre-VBT (7.94 vs 3.81; P < .001). Multivariable regression analysis indicated that each additional hour of average daily VBT application was associated with a 1.7-mm reduction in funnel depth. Greater baseline severity also was associated with larger residual deformity at follow-up. Overall, 67.5% of the patients showed clinical improvement.
Conclusions: The findings support the use of VBT as a safe and effective noninvasive intervention for pediatric patients with PE. Treatment adherence and baseline deformity severity are key factors influencing outcomes.
Citation
AlShammari A, Santhirakumaran G, Patel A, Hunt I. Prospective evaluation and successful outcomes using vacuum bell therapy for pectus excavatum in selected pediatric patients: Analysis of a prospective cohort study of 240 patients. J Thorac Cardiovasc Surg. 2025 Nov 4:S0022-5223(25)00964-X. doi: 10.1016/j.jtcvs.2025.10.036. Epub ahead of print.
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Article