Use of a 3D-printed custom-designed tracheostomy tube to stabilise a permanent tracheostoma in a 25-year-old Icelandic mare

A 25-year-old Icelandic mare diagnosed with bilateral temporohyoid-osteoarthropathy, moderate pharyngeal instability and bilateral laryngeal paralysis was presented because of intermittent stridor and dyspnoea worsening during exercise. As a previous ceratohyoidectomy had not improved these symptoms substantially, a permanent tracheostomy was performed. After development of a surgical site infection and dehiscence followed by revision, the final stoma collapsed at times, especially during exercise, resulting in respiratory distress. To stabilise the stoma, a tracheotomy tube was constructed with Autodesk Fusion (R) and printed from TPU-95 material with an Ultimaker (R) S5 3D-printer. The parametric design allowed fast adaptation in size, shape and stiffness as wound healing progressed. Precision adjustments of size and shape were conducted on an ambulatory basis over a period of several weeks. Intermittently placed by the owner, the device prevented stoma collapse during exercise and was well tolerated by the horse without causing irritation or pressure sores. It was easy to clean, soft but robust and could be replaced and adapted easily. The present case suggests that a 3D-printed tracheotomy tube is an affordable and effective measure to stabilise a permanent tracheostoma and resulted in improved airway function of the affected horse.

Pferdeklinik Tillysburg