Tracheobronchomalacia is a condition of dynamic collapse of the trachea and mainstem bronchi. The clinical significance of tracheobronchomalacia depends on its severity. Mild cases may be medically managed with limited symptomology, while severe cases require advanced therapies, lengthy hospital stays, and carry significant morbidity and mortality. Current therapies for severe tracheobronchomalacia include tracheostomy with prolonged mechanical ventilation, aortopexy, tracheobronchopexy, and intraluminal metallic, silicone, or bioresorbable stents. Three-dimensional (3D)-printed, patient-specific, bioresorbable airway splinting is a novel treatment option that is undergoing investigation in a cohort of critically ill children with severe tracheobronchomalacia. At the time of our last review of our data, 29 splints had been implanted in 15 children with intrathoracic tracheobronchomalacia. The median follow-up was 8.5 months. There were 12 long-term survivors, and all but one lived at home. This article discusses the details of our institution's development and use of 3D-printed, patient-specific, bioresorbable splints for treatment of severe tracheobronchomalacia in the pediatric population.
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http://dx.doi.org/10.1053/j.pcsu.2021.02.001 | DOI Listing |
J Cardiothorac Surg
December 2024
Chirurgie Thoracique et Vasculaire, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France.
Background: A 51-year-old woman was referred to our department due to chronic dry cough lasting six years without an etiological diagnosis. The patient suffered from chronic deterioration in her quality of life due to a persistent cough that sounded like a barking seal.
Case Presentation: A severe form of malacia involving the inferior third of trachea and the main bronchi was diagnosed.
BMJ Open
December 2024
Congenital Oesophageal and Airway Team Utrecht, Departments of Paediatric Surgery and Otorhinolaryngology and Head and Neck Surgery, Wilhelmina Children's Hospital University Medical Center, Utrecht, The Netherlands.
Introduction: Tracheomalacia (TM) often occurs in children with oesophageal atresia (OA), leading to recurrent respiratory symptoms and in severe cases to blue spells or ultimately respiratory arrest. In some patients, a secondary posterior tracheopexy may then be indicated. This secondary surgery, as well as respiratory morbidity, may be prevented by performing a primary posterior tracheopexy (PPT) concurrent with primary OA correction.
View Article and Find Full Text PDFJ Biomed Mater Res B Appl Biomater
December 2024
J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Luskin Orthopaedic Institute for Children in Alliance With UCLA, Los Angeles, California, USA.
Severe infantile tracheobronchomalacia (TBM) is often treated with invasive surgery and fixed-size implants to support the trachea during respiration. A novel 3D-printed extra-luminal splint has been developed as a flexible and bioresorbable alternative. Therefore, the goal of the present study was to use an in vitro breathing simulator model to comprehensively evaluate the structural stiffness and failure modes of two sizes of a novel bioresorbable 3D-printed splint design under a range of physiological degradation conditions.
View Article and Find Full Text PDFChest
November 2024
Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan province, P. R. China. Electronic address:
Thorac Surg Clin
February 2025
Division of Thoracic Surgery, Robert Wood Johnson Barnabas Health, Long Branch, NJ, USA. Electronic address:
Tracheobronchomalacia (TBM) is a frequently under-recognized condition that often coexists with other chronic respiratory diseases. The diagnosis of excessive central airway collapse requires consideration by the physician. Dynamic computed tomography scan of the chest and awake dynamic bronchoscopy are critical to establishing a diagnosis of TBM.
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