The clinical challenge
For children born with a narrowing of their larynx/ trachea, a stent is placed to restore the airways to enable normal breathing and vocalisation and remove any need for a lifelong tracheostomy (a small plastic tube inserted through a surgically created opening).
Pre- existing stents are typically created for adults and so were not small, nor soft enough, for such a young patient. Rigid enough to support structure, yet soft and compliant enough to avoid tissue damage and resist needle puncture — that balance is extremely difficult to achieve in very small patients.
Solving the issue
In a landmark case, published in Advanced Functional Materials, researchers from UCL along with colleagues in Great Ormon Street Hospital, applied a personalised stent in a 5-month old infant with a severe airway malformation. The UCL-GOSH team designed the stent with better matched mechanical properties and surface softness from a combination of 3D printing and resin fusion of medical-grade materials.
The stent remained in place for 6 weeks post-surgery, after which it was safely removed, and the airways having healed well around it. The child's tracheostomy was removed at 27 months, far earlier than expected with conventional care (where the reconstructive process would only have been initiated at age 2). Eight years later, the patient has normal breathing, speech and swallowing.
This demonstrates not only safety and feasibility, but long-term functional success. It also opens the door for more children to receive reconstructions that were previously deemed infeasible due to size constraints.
Implications
This breakthrough highlights how advanced material design in combination with 3D-printing techniques and close collaboration between engineers and surgeons can rapidly deliver solutions when commercial devices fall short.
There’s long-term functional success. The research carried out here opens the door for more children to receive reconstructions that were previously deemed infeasible due to size constraints.
Key Investigators:
- Dr Wenhui Song, Professor of Biomaterials and Medical Engineering, the UCL Centre for Biomaterials in Surgical Reconstruction and Regeneration, Division of Surgery and Interventional Science
- Dr. Elizabeth Maughan, Colin Butler and Richard Hewitt, Department of Otorhinolaryngology, Great Ormond Street Hospital NHS Foundation Trust, London,
