BackgroundThe use of three-dimensional printing has been rapidly expanding over the last several decades. Virtual surgical three-dimensional simulation and planning has been shown to increase efficiency and accuracy in various clinical scenarios.ObjectivesTo report the feasibility of three-dimensional printing in paediatric laryngotracheal stenosis and discuss potential applications of three-dimensional printed models in airway surgery.MethodRetrospective case series in a tertiary care aerodigestive centre.ResultsThree-dimensional printing was undertaken in two cases of paediatric laryngotracheal stenosis. One patient with grade 4 subglottic stenosis with posterior glottic involvement underwent an extended partial cricotracheal reconstruction. Another patient with grade 4 tracheal stenosis underwent tracheal resection and end-to-end anastomosis. Models of both tracheas were printed using PolyJet technology from a Stratasys Connex2 printer.ConclusionIt is feasible to demonstrate stenosis in three-dimensional printed models, allowing for patient-specific pre-operative surgical simulation. The models serve as an educational tool for patients’ understanding of the surgery, and for teaching residents and fellows.
Real-time EMG recordings were sensitive to C5 nerve root irritation, whilst SSEPs and TcMEPs were not. Sustained EMG activity of the C5 nerve root during surgery is a possible warning sign of irritation or injury to the nerve.
It is feasible to assume that continuous and direct pressure on the inguinal region during surgery on Jackson table was the primary cause of the iliac artery occlusion, particularly in these patients with known peripheral vascular disease. Early recognition and prompt vascular intervention can prevent serious sequelae.
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