Patients with chest wall conditions and injuries can now obtain comprehensive care through the Jefferson Center for Chest Wall Disorders.
Led by Olugbenga Okusanya, MD, Associate Professor of Surgery, the Center offers innovative procedures for Pectus Excavatum, Thoracic Outlet Syndrome (TOS), Slipping Rib Syndrome, as well as rib and sternum fractures and several other non-cancerous chest wall conditions.
“The center formalizes our team-based approach to getting the best outcomes for patients,” Dr. Okusanya explains.
Dr. Okusanya routinely collaborates closely with his partners in thoracic surgery: Drs. Nathaniel Evans, Tyler Grenda, and John Jacobs. The team also includes trauma surgeons Drs. David E. Lapham, Jessica Latona, Claudia Lozano-Guzman, and Alec Beekley; rehabilitation medicine specialists Drs. Shawn Peterson and Marisa Moreta; anesthesiologist Dr. Jeffrey J. Mojica; radiologist Dr. Johannes Roedl; vascular surgeon Dr. Paul DiMuzio and neurosurgeon Dr. Shrinivas Prasad. The entire team is supported by Sung Wang, DNP, CRNP, from the Department of Surgery.
Innovative treatment for adults with Pectus Excavatum
In people with Pectus Excavatum, the rib cage develops abnormally, and the breastbone is depressed inward. The result is an indentation of the chest wall that can cause respiratory complications and affect self-image and emotional development. Dr. Okusanya says that the condition is often—but not always—diagnosed and corrected in childhood.
“In adults, Pectus Excavatum isn’t always visible, and symptoms like palpitations, shortness of breath, chest pain and exercise intolerance are sometimes incorrectly diagnosed as anxiety disorders,” Dr. Okusanya notes. “When patients present with these symptoms, primary care providers should refer them to us for a full evaluation.”
Given the larger size and greater rigidity of adult chest walls, surgical correction is more complex than in pediatric cases. Jefferson offers the Nuss procedure, a minimally invasive surgery that involves insertion of one to three curved metal bars behind the sternum to push it into a normal position. Dr. Okusanya and his colleagues also incorporate advanced techniques, including cryo nerve ablation for pain control and video-assisted thoracoscopy (VATS) to help visualize the chest and surrounding areas during surgery.
“With cryo nerve ablation, we freeze the nerves on both sides of the chest to help control pain for three to six months—dramatically reducing the need for opioid use after surgery,” he says.
Multidisciplinary care for other chest wall diseases
The center also cares for patients with TOS, in which ribs and muscles in the upper part of the chest and neck compress the blood vessels and nerves going into the arm. Patients experience significant arm, shoulder and chest symptoms.
The solution is often to remove the first rib and decompress the nerves and blood vessels. While Dr. Okusanya performs the procedure through the chest, Dr. DiMuzio performs the procedure via an open approach in the neck.
“Jefferson is one of the few places offering multiple approaches to fixing TOS and a multidisciplinary team to help manage symptoms before and after surgery,” he notes.
In Slipping Rib Syndrome, one or more ribs become hypermobile, which irritates nerves and causes local pain and discomfort. With both TOS and Slipping Rib Syndrome, patients often suffer for years before receiving accurate diagnosis and appropriate treatment—a reality Dr. Okusanya is hoping to change.
“We routinely evaluate patients who are dealing with issues related to hypermobility, pain and compression,” he concludes. “Send patients to us—we can help identify potentially life-changing treatments.”
For more information, visit jeffersonhealth.org/ChestWallCare.
Recommended Citation
(2024)
"New Center Offers State-of-the-Art Treatment for Chest Wall Disorders,"
Jefferson Surgical Solutions: Vol. 20:
Iss.
1, Article 4.
Available at:
https://jdc.jefferson.edu/jss/vol20/iss1/4
The Center for Chest Wall Disorders offers patients the combined expertise of over a dozen specialists. The team includes Director, Olugbenga Okusanya, MD (2nd from left), Sung Wang, DNP, CRNP, Jessica Latona, MD (Trauma Surgery), Shawn Peterson, DO (Rehabilitation Medicine).