In a pioneering case that showcases the potential of patient-specific 3D printing in pediatric medication, a multidisciplinary staff on the Mayo Clinic has efficiently developed and carried out a totally individualized 3D printed tracheostomy tube for a younger affected person affected by recurrent, life-threatening tracheal erosion. The case, lately printed in Otolaryngology Case Studies, marks the primary documented occasion of a 3D printed tracheostomy tube getting used to handle vertebral erosion attributable to a standard tracheostomy cannula.
The affected person, a 14-year-old lady with a fancy medical historical past together with pontocerebellar hypoplasia kind 1B, neuromuscular scoliosis, and long-standing tracheostomy dependence, introduced with a uncommon and extreme complication: full-thickness erosion of the posterior tracheal wall into the vertebral our bodies. This situation was exacerbated by progressive lack of thoracic kyphosis and the narrowing of the anterior-posterior diameter of her thoracic inlet, which distorted the pure curvature of the trachea. Commercially accessible tracheostomy tubes have been unable to accommodate this anatomy with out exerting damaging strain on the trachea, in the end contributing to the erosion and elevating alarm for potential vertebral osteomyelitis, a life-threatening complication.
Beforehand, the affected person had undergone invasive thoracic surgical procedures, together with manubriectomy and reimplantation of the innominate artery, which had quickly resolved her signs. Nevertheless, as her situation progressed and surgical choices diminished, the care staff pursued a novel route: the creation of a customized tracheostomy tube utilizing 3D printing applied sciences.
Utilizing a high-resolution CT scan of the affected person’s thorax, engineers designed a tube that exactly adopted the tortuous path of her trachea whereas avoiding the ulcerated areas. The system was printed in a dental-grade biocompatible resin—poly methacrylate—chosen for its sturdiness, clean end, and suitability for sterilization. The tube was fabricated utilizing FDA-cleared software program and tools usually employed for sophistication II medical units. The ultimate design replicated the size of the affected person’s earlier tracheostomy tube however featured an adjusted curvature to stop strain on the tracheal wall.
Following approval for compassionate use by the FDA and the Mayo Clinic’s IRB, the customized tube was positioned throughout a bronchoscopy process. Not like the usual tube, which had veered into the erosion website and contributed to granulation tissue formation, the 3D-printed tube aligned with the midline of the trachea and bypassed the ulcer fully. Put up-placement outcomes have been outstanding: the affected person’s ache resolved, there have been no indicators of an infection, and follow-up imaging revealed the regrowth of wholesome tracheal tissue and correct anatomical alignment. Repeat bronchoscopy at eight weeks confirmed full therapeutic of the ulcer, with solely minor granulation tissue remaining.
At almost three years of follow-up, the tube stays in place with out issues. Minor changes have been made to handle early points, together with a strain ulcer on the stoma and problem threading ties by way of the tube’s eyelets. These have been resolved by redesigning the flanges and enlarging the tie openings, enhancements made rapidly because of the pliability of in-house 3D printing.
This case underscores the distinctive wants of pediatric sufferers with complicated anatomical deformities and the constraints of off-the-shelf medical units. In conditions the place anatomy deviates considerably from the norm—significantly in situations like hypokyphotic scoliosis—customized options could not simply be useful however important. The authors emphasize the numerous benefits of regionally manufactured, patient-specific airway units: speedy turnaround, cost-efficiency, and flexibility to anatomical adjustments over time.
Whereas customized tracheostomy units have beforehand been modeled and fabricated by way of third-party producers, this marks the primary occasion of a wholly 3D-printed tracheostomy tube getting used instantly in a medical setting. Its success opens the door for broader use of 3D printing in managing complicated pediatric airway instances and alerts a promising shift towards personalised medication, particularly in affected person populations underserved by standard system markets.
The research’s authors—Dr. Ibrahim Serhat Karakuş, Adam J. Wentworth, Dr. Jonathan M. Morris, and Dr. R. Paul Boesch—collectively signify experience in pulmonology, biomedical engineering, and medical 3D printing. Collectively, they advocate for elevated exploration of 3D-printed units to fulfill the individualized wants of pediatric sufferers with anatomical challenges the place conventional interventions fall quick.