A Bespoke Programmable Interpenetrating Elastomer Network Composite Laryngeal Stent for Expedited Paediatric...

Laryngotracheal reconstruction surgery (LTR) is the standard treatment for paediatric upper airway stenosis, enabling tracheostomy decannulation, and restoration of vocalization. In complex infant cases, postoperative stenting is essential for graft integration and minimization of restenosis, yet available off-the-shelf stents are often unsuitable for small patients. Here, a case of acquired-on-congenital laryngeal atresia is reported, where early reconstruction in infancy was performed. To support this intervention, a personalized laryngeal stent was developed from a digitally programmable interpenetrating elastomer network (IEN) composite tailored to the patient's anatomy, balancing structural stiffness with surface softness. The stent was fabricated by combining 3D inverse-printed thermoplastic polyurethane (3D-TIPS) scaffolds with vacuum-assisted silicone resin infusion, yielding an elastomer with tenable geometry, hardness, and biomechanical compliance optimized for paediatric use. Manufactured in accordance with UK Good Manufacturing Practice guidelines, the stent was deployed during LTR at 5 months of age and safely removed after 6 weeks. The stented repair healed well, with decannulation at 27 months. At 8-year follow-up, the patient demonstrates strong vocalization, good airway protection, and normal swallowing. Beyond this case, this work establishes a versatile platform for rapid manufacture of patient-specific elastomer implants with programmable mechanical and surface properties for soft-tissue reconstruction.