Mini ReviewOpen Access

Moving Beyond the Haller Index as a Measure of Pectus Excavatum Severity

Volume 2 - Issue 1

**Robert S Eisinger¹* and Hans K Pilegaard²**

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- ¹University of Florida College of Medicine, Gainesville, Florida
- ²Dept. of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark and Dept. of Clinical Medicine, Aarhus University, Aarhus, Denmark
*Corresponding author: Robert S Eisinger, University of Florida College of Medicine, Gainesville, Florida 1275 Center Drive, Gainesville, FL 32611, Florida

Received: December 21, 2017; Published: January 08, 2018

DOI: 10.26717/BJSTR.2018.02.000640

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Abstract

Due to increased awareness and recent advances in the minimally invasive repair of Pectus Excavatum (PE), a growing number of PE patients are considering corrective treatment. But patients and clinicians are faced with a pressing question: What are the indications for surgery? Due to the paucity of prospective PE studies, data-driven guidelines are currently lacking. The Haller index (HI) has emerged as the predominant way to identify patients for which surgical treatment is most appropriate. Under this premise, patients with higher HI values – indicating a more severe chest deformity – are more likely to pursue and/or benefit from surgery. However, evidence is accumulating that HI may not accurately portray the underlying physiologic disruption or the symptoms associated with PE. In this Viewpoint, we discuss the origin of HI and describe its widespread use in practice today, despite its possible shortcomings, as well as alternative approaches for evaluating PE severity.

Abbreviations: PE: Pectus Excavatum; HI: Haller index; CT: Computed Tomography

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