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Three-dimensional Modeled T-tube Design and Insertion in a Patient With Tracheal DehiscenceThree-dimensional Modeled T-tube Design

George Z. Cheng, MD, PhD; Erik Folch, MD; Robert Brik, MS; Sidhu Gangadharan, MD; Pavan Mallur, MD; Jennifer H. Wilson, MD; Bryan Husta, MD; Adnan Majid, MD, FCCP
Author and Funding Information

From the Division of Thoracic Surgery and Interventional Pulmonology (Drs Cheng, Folch, Gangadharan, Wilson, Husta, and Majid and Mr Brik) and the Section of Otology and Laryngology (Dr Mallur), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

CORRESPONDENCE TO: Adnan Majid, MD, FCCP, Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Rd, Deaconess-201, Boston, MA 02215; e-mail: amajid@bidmc.harvard.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(4):e106-e108. doi:10.1378/chest.15-0240
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A 68-year-old man with recurrent medullary thyroid cancer underwent cervical tracheal resection and reconstruction. His course was complicated by tracheal anastomotic dehiscence, right carotid blowout, and ultimately cervical tracheoplasty with AlloDerm. Given the complex vascular interventions and upper-airway anatomy, a custom-designed Montgomery T-tube was designed for him. Three-dimensional digital reconstruction of his upper airways was obtained from a CT scan. The T-tube was designed and fabricated based on the digital trachea model and was subsequently placed successfully. Follow-up CT scan and bronchoscopy confirmed placement and revealed no granulation tissue at 4 weeks. The patient was discharged to home with the ability to phonate. To our knowledge, this is the first demonstration of three-dimensional modeling of an upper-airway defect with subsequent T-tube design using engineering software. The success of this case demonstrates a possible avenue for personalized airway prosthesis design and manufacturing in the future.

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