Ever since he was six weeks old, baby Kaiba often stopped breathing. The part of his windpipe that carries air to his left lung would suddenly collapse, leaving him unable to breathe and requiring emergency assistance every time.
Kaiba had a condition called tracheobronchomalacia. It’s a rare condition – about 1 in 2,200 babies are born with tracheomalacia and most children grow out of it by age 2 or 3, although it is often misdiagnosed as asthma that doesn’t respond to treatment.
Severe cases, like Kaiba’s, are even more rare, and they are very frightening.
It’s a condition that has bothered me for years. Children die from tracheobronchomalacia, but I hoped that help could be found for these children.
Kaiba’s parents, April and Bryan, were left watching helplessly each time he stopped breathing, praying that something would change and doctor’s predictions that he would never leave the hospital again weren’t true.
They lived in Ohio but they were willing to go anywhere if it meant they could get help for Kaiba. Fortunately, they didn’t have to go far.
My colleague Scott Hollister and I had been working on a type of device that would be perfect to help splint little Kaiba’s airway, keeping it clear for air to continually flow to the lungs.
Scott is actually a professor of biomedical engineering and mechanical engineering – but that’s the great thing about being a doctor at the University of Michigan. The very campus we work on is full of some of the brightest minds in the world. With creativity, imagination, and the willingness to cross boundaries to work with scientists of different backgrounds, you can find ways to explore nearly any idea you could imagine to improve the way we deliver healthcare.
Scott and I had been exploring creating implants using a type of biodegradable polyester called polycaprolactone for a while, but it had never been used in this way before. Because of the urgency of Kaiba’s life threatening condition, though, we were able to get emergency clearance from the Food and Drug Administration to create a tracheal splint for him, using the material.
We custom designed Kaiba’s splint using high-resolution images from a CT scan of Kaiba’s trachea and the bronchus that was collapsing. Using computer-aided design and a special laser-based 3-D printer, we produced the splint specifically to fit Kaiba’s needs.
On February 9, 2012, Kaiba’s parents entrusted us with Kaiba’s care, and we took him back to the operating room for the procedure to implant the splint. The splint was sewn around Kaiba’s airway to expand the airway and give it a skeleton to help it grow properly and with greater strength. Over about three years, the splint will be reabsorbed by the body.
As soon as the splint was put in, the lungs started going up and down for the first time and we knew he was going to be OK.
Kaiba was off ventilator support 21 days after the procedure, and has not had breathing trouble since then.
For Scott and I, Kaiba’s case is definitely the highlight of our careers so far. To actually build something that can save a person’s life? It’s a tremendous feeling.
The image-based design and 3-D biomaterial printing process we used for Kaiba can be adapted to build and reconstruct a number of tissue structures. We’ve used the process to build and test patient-specific ear and nose structures. Scott has also used the method with other collaborators to rebuild bone structures in pre-clinical models.
We’re excited about what we could do for Kaiba, but there are many other kids like him that need this type of treatment and don’t have access to it. The challenge before us now is to find a way to refine the technology, test it, and make it available for other children all over the world. That’s what research and clinical trials do, and we intend to make that happen.
- Help support Dr. Green’s and Dr. Hollister’s work for children with tracheobronchomalacia
- Read about Dr. Green’s work in the New England Journal of Medicine and the University of Michigan Health System press release
This story in the news:
- Doctors use 3-D printer to custom-design implant for baby (USA Today)
- A medical first: Doctors save Ohio boy by ‘laser-printing’ an airway tube so he can breathe (Washington Post)
- 3-D printer helps save dying baby (CNN)
- 3-D Printed Medical Device Saves a Life for the First Time (U.S. News & World Report)
Glenn Green, MD, is a pediatric otolaryngologist at University of Michigan C.S. Mott Children’s Hospital. His areas of specialization are complex pediatric airway disorders, hearing and language development, and care of children with a congenital syndrome.
University of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.