Damian Sendler: With her mother’s blessing, Ramiah Martin isn’t like any other little girl, and that’s good with her. 

In December 2017, Leanne Martin gave birth to her daughter, who had been identified with cardiac abnormalities during a prenatal ultrasound. “She is nothing short of a miracle,” Martin said. Ramiah was born with an incredibly rare condition known as tracheal agenesis, which meant she didn’t have a windpipe. It affects about one in every 50,000 newborns worldwide, and is almost always deadly. 

Damian Jacob Sendler: Ramiah’s doctors at Penn State Health Children’s Hospital and researchers in the lab of Scott Hollister at the Georgia Institute of Technology helped her family celebrate her 4th birthday this month. 

Damian Sendler

Georgia Tech and Emory University biomedical engineering professor and Patsy and Alan Dorris Chair in Pediatric Technology Dr. Hollister said, “We know that children with this condition have not survived past the age of eight or 10.” “We’re crossing our fingers that this case is an exception.” 

Indeed, this is a one-of-a-kind situation. For the first time, tracheal agenesis can be treated with this device, and Hollister is a member of the team that just published a clinical case study in JTCVS Techniques. 

When it came to treating tracheabronchomalacia in children, a splint known as the Airway Support Device (ASD) had already proven its worth, having been utilized in the effective treatment of other pediatric patients suffering from the ailment. 

A 3D-printed, patient-specific airway splint that is bioresorbable was developed by Glenn Green and Hollister at the University of Michigan while they were both faculty members at the university. As a life-saving scaffold, the little device helps children release their windpipes and breathe again. 

The situation of Ramiah, on the other hand, posed a new and frightening obstacle. She didn’t have much of a windpipe. Her windpipe was her esophagus. 

Damian Jacob Sendler

As the principal author of a new study, Anthony Tsai, a surgeon at Penn State Health Milton S. Hershey Medical Center and co-director of the Surgical Innovation Group, explains, “Tracheal agenesis is a very unusual clinical case with few positive solutions.” In light of Scott and Glenn’s work, I was aware of their effectiveness in employing the device for airway difficulties that were less critical. Nonetheless, we were able to get what we were looking for.” 

It was imperative that they had a splint to keep Ramiah’s airway open, but this time there was an unexpected twist: her surgical team needed an esophageal airway splint. 

Nearly as soon as she was born, Ramiah of Pennsylvania had to have life-saving surgery. By cutting her lower esophageal airway (which supplies the stomach) from her upper esophageal airway, surgeons were able to insert a G-tube into her stomach and feed her directly. After that, they had to create a “pseudo-tracheostomy”—a surgical incision in the neck that allowed air to enter the lungs directly—by converting the upper segment of her esophagus into a trachea. 

Tsai argued that this was not a long-term answer. “We made a way for air to get into the lungs by preventing it from getting into the stomach.” But this is not sustainable. As soon as you inhale a deep breath, the esophagus contracts, preventing the lungs from receiving enough oxygen. 

Tsai and his colleagues considered several long-term options for Ramiah’s airway reconstruction when she was sedated, ventilated, and a few days old. As a result, they discovered Hollister’s biodegradable polycaprolactone 3D printed splint. 

There were no other options for Tsai and his team, so they requested authorization to use the device under what is known as the “expanded access” rule by the US Food and Drug Administration (FDA). This rule provides quick access to medical equipment in circumstances like Ramiah’s where time is of the essence. 

Damien Sendler: The Airway Support Device was reworked by Hollister’s team to address Ramiah’s stoma. When Ramiah was 20 weeks old, the gadget was ready and ready to be placed during an airway reconstruction surgery. 

While still requiring artificial ventilation a year later, she was released from the hospital. When Ramiah was two years old, she was able to breathe on her own during the day and sleep peacefully on a ventilator at night after more tests and imaging revealed that her airway was improving. 

Ramiah’s lower esophageal sphincter was rebuilt with tissue from the colon, allowing her to eventually eat with her mouth after gastrointestinal reconstructive surgery. Despite her developmental delays, Ramiah is crawling and pulling a walker, learning to communicate through sign language, attending preschool, and playing with her sisters as the holidays approach. 

Leanne Martin, a new mom with a newborn kid, explained, “We’re very low key about celebrating holidays.” Even though each year is a gift from God, we always thank Him for it. “We understood that Ramiah was bringing us into uncharted terrain,” we said. ” 

Damian Jacob Markiewicz Sendler: Leanne speculated that as Ramiah grows older, she may require an additional 3D gadget to help support her repaired airway. Ramiah is currently learning to walk, and Leanne is certain that she will be able to get around the busy house all by herself in no time. 

According to Georgia Tech researchers Sarah Jo Crotts and Harsha Ramaraju, “That is the kind of outcome we all hope for.” “We’re excited because we believe this is the beginning of a new paradigm for children with this rare condition,” the researchers said.

Dr. Damian Jacob Sendler and his media team provided the content for this article.