At the Boston Children’s Vascular Ring and Airway Compression Program, we are always exploring new ways to better diagnose and treat vascular rings and airway compression. Here are some recent advances that allow us to create a personalized treatment plan for each patient and perform minimally invasive surgery safely and with precision.
Creating custom-fitted and better-quality airway stents
Conventional stents placed inside the airway to treat tracheobronchomalacia can slide out of place, prevent the movement of mucus, or get stuck in airway tissue. Boston Children’s has designed a new airway stent to better support patients. The stent doesn’t prevent the flow of mucus, is easy to remove, and can be custom-molded to snugly fit a patient’s anatomy.
Soft stents, hardened in place by UV light, allow a snug, custom fit
An airway stent, custom-fit in real time, could benefit patients with tracheobronchomalacia. The design may be adaptable for heart implants.
An airway splint that doesn’t go in the airway
As an alternative to an airway stent, our team has devised a technique to custom fabricate a tracheobronchial splint that can hold open a patient’s airway without being placed inside the airway — and the device will be naturally absorbed by the body over time.
Improving the safety of vascular ring surgery
We’re always looking to improve how we protect critical nerves during vascular ring operations. One such recent step was changing how we monitor the recurrent laryngeal nerve — which controls the muscles of the voice box. Sometimes, it is difficult to find in children who have already had surgery in that area. To better track the nerve during an operation, we adapted the technology behind intraoperative nerve monitoring (IONM), a technique that’s used in surgeries that pose a risk to the nervous system. Using IONM, we’re able to precisely identify the recurrent laryngeal nerve’s location and monitor it during vascular ring operations. We also are sure to check vocal cord function both before and after surgery to ensure each patient is closely monitored and appropriate follow-up is recommended as needed.
Quantifying and tracking patient symptoms
It’s important to have a comprehensive view of the health of children with esophageal and tracheal symptoms. We are developing methods that will give us the ability to measure and track a child’s symptoms before treatment and after an operation. Our hope is that a better understanding of a patient’s condition will improve our ability to identify those who are most likely to benefit from surgery.