Virtual 3D planning of tracheostomy placement and clinical applicability of 3D cannula design: A three-step study

de Kleijn, B. J., Kraeima, J., Wachters, J. E., van der Laan, B. F. A. M., Wedman, J., Witjes, M. J. H. & Halmos, G. B., Feb-2018, In : European Archives of Oto-Rhino-Laryngology. 275, 2, p. 451-457 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

AIM: We aimed to investigate the potential of 3D virtual planning of tracheostomy tube placement and 3D cannula design to prevent tracheostomy complications due to inadequate cannula position.

MATERIALS AND METHODS: 3D models of commercially available cannula were positioned in 3D models of the airway. In study (1), a cohort that underwent tracheostomy between 2013 and 2015 was selected (n = 26). The cannula was virtually placed in the airway in the pre-operative CT scan and its position was compared to the cannula position on post-operative CT scans. In study (2), a cohort with neuromuscular disease (n = 14) was analyzed. Virtual cannula placing was performed in CT scans and tested if problems could be anticipated. Finally (3), for a patient with Duchenne muscular dystrophy and complications of conventional tracheostomy cannula, a patient-specific cannula was 3D designed, fabricated, and placed.

RESULTS: (1) The 3D planned and post-operative tracheostomy position differed significantly. (2) Three groups of patients were identified: (A) normal anatomy; (B) abnormal anatomy, commercially available cannula fits; and (C) abnormal anatomy, custom-made cannula, may be necessary. (3) The position of the custom-designed cannula was optimal and the trachea healed.

CONCLUSIONS: Virtual planning of the tracheostomy did not correlate with actual cannula position. Identifying patients with abnormal airway anatomy in whom commercially available cannula cannot be optimally positioned is advantageous. Patient-specific cannula design based on 3D virtualization of the airway was beneficial in a patient with abnormal airway anatomy.

Original languageEnglish
Pages (from-to)451-457
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number2
Early online date24-Nov-2017
Publication statusPublished - Feb-2018


  • Journal Article, DUCHENNE MUSCULAR-DYSTROPHY, Neuromuscular disease, Tracheostomy, 3D planning, Cannula

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