2020 Volume 56 Issue 7 Pages 1114-1122
Sternal cleft is a rare congenital deformity caused by birth defects in the sternum. We report two cases of closure of a simple sternal cleft. Case 1: A 2-year-old girl was referred to our department because of neck protrusion during breathing. Upper sternal cleft was diagnosed, and surgery was performed. Although the perichondrium of the sternal comb was peeled off, the tension was so strong that part of the costal cartilage was cut off. The inferior sternal fusion was excised in a wedge shape. She was discharged eight days after surgery. Case 2: A two-month-old girl was found to have a depression in the suprasternal fossa after birth. She was diagnosed as having complete sternal cleft and was operated on. After detaching and closing the perichondrium, the lower part showed almost no adhesion and was completely transected. A part of the costal cartilage was cut off, and the sternum was closed. Blood pressure decreased at the time of the initial closure, and she was administered catecholamine. She was discharged on the 9th postoperative day. Early surgical stabilization of the thorax is preferred immediately after diagnosis because the thoracic and mediastinal tissues are pliable at the early stage of development. However, the surgical procedure and timing of surgery require careful consideration in neonates and infants in whom respiration and circulation are difficult to manage during the perioperative period.
