In a first-of-its-kind procedure, a biomaterial splint crafted using a combination of CT imaging and 3D printing was used to repair an infant’s airway and save the baby’s life. The case was described in published correspondence May 23 in the New England Journal of Medicine.
By the time the patient, Kaiba Gionfriddo, was two months old, he required endotracheal intubation to sustain breathing. It was discovered that Kaiba had a rare condition called tracheobronchomalacia, which manifests with dynamic airway collapse and respiratory insufficiency, according to Glenn Green, MD, of the University of Michigan (UM), Ann Arbor, and colleagues. Despite use of the tracheostomy tube, Kaiba would continually stop breathing and required daily resuscitation.
Green and his UM colleagues consulted with the FDA and received approval under the emergency-use exemption to implant a specially-designed splint to repair Kaiba’s airway. Using CT images of the airway, computer-aided design and laser-based 3D printing, a custom resorbable splint was fabricated out of a biopolymer called polycaprolactone.
“Our bellowed topology design, similar to the hose of a vacuum cleaner, provides resistance against collapse while simultaneously allowing flexion, extension, and expansion with growth,” wrote the authors.
Green and colleagues had previously used the process to craft patient specific ear and nose structures in pre-clinical models, according to UM.
Kaiba’s procedure occurred on Feb 9, 2012, at C.S. Mott Children’s Hospital in Ann Arbor. Seven days after splint placement, Kaiba began to be weaned from mechanical ventilation, and by 21 days he was completely off the ventilator and discharged home, reported Green and colleagues. After one year, no unforeseen problems had developed. Full resorption of the splint is expected within three years.
“This case shows that high-resolution imaging, computer-aided design, and biomaterial three-dimensional printing together can facilitate the creation of implantable devices for conditions that are anatomically specific for a given patient,” wrote Green and colleagues.
For more on this procedure, you can view the UM-produced video below: