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Ann Thorac Surg 1984;37:204-211
© 1984 The Society of Thoracic Surgeons

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Articles

Poland's Syndrome: Improved Surgical Management

From the Baylor University Medical Center, Dallas, TX

^* Address reprint requests to Dr. Urschel, Baylor Medical Plaza, 1201 Barnett Tower, 3600 Gaston Ave, Dallas, TX 75246

Single-stage reconstruction of the chest wall combined with simultaneous augmentation mammoplasty and transfer of an island pedicle myocutaneous flap of latissimus dorsi muscle are major improvements over previous multiple-stage procedures that provide less satisfactory cosmetic results in management of patients with Poland's syndrome. Utilization of the single-stage technique in 2 patients demonstrated its efficacy as proven by excellent cosmetic results. In 1 patient with absent second, third, and fourth costal cartilages and ribs, Marlex mesh covered with a synthetic dura mater graft was employed to stabilize the chest wall. Simultaneously, an island pedicle myocutaneous flap of latissimus dorsi with its neurovascular bundle preserved was transferred to cover the prosthesis. The other patient had a coexistent pectus carinatum defect, which was repaired by resection of the costal cartilages and osteotomy of the sternum without use of Marlex. The breast implant was covered concomitantly with the myocutaneous flap of latissimus dorsi. No morbidity or mortality occurred. The cosmetic and functional results are superior to those obtained with standard techniques.

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				J. A. Haller Jr. Operative Management of Chest Wall Deformities in Children: Unique Contributions of Southern Thoracic Surgeons Ann. Thorac. Surg., July 1, 1988; 46(1): 4 - 12. [PDF]