Table 1.

Patient-Specific Airway Abnormalities, Personal Tracheostomy Tube Indications and Modifications, and Posttreatment Outcomes.

Characteristics	Patient 1	Patient 2	Patient 3
Congenital airway anomaly	Tracheobronchial stenosis, TCS, tracheal tortuosity	TCS	Thoracic cavity constriction causing vertical airway buckling and high ventilatory pressures. Progressive tracheal tortuosity with focal tracheomegaly
Primary diagnosis	Apert syndrome	Pfeiffer syndrome	Metatropic dysplasia
Indication for vapTTa	UAO; RLD; recurrent hypoxic, hypercapnic respiratory failure. Cartilage exposure, ulceration, and granulation	UAO; RLD; recurrent hypoxic, hypercapnic respiratory failure	UAO; RLD; recurrent hypoxic, hypercapnic respiratory failure. Cartilage exposure, granulation formation, and thoracic vertebral erosion and remodeling
Triplanar customizationsb	45° in the axial plane and 20° anterior angulation in the sagittal plane at 1 cm from the distal tip of the tube	22.5° anterior angulation in the sagittal plane 5 mm from the distal tip of the tube	22° lateral bend in the coronal plane 1 cm from the tip of the tube. Mirrored S-shaped bend, custom length, custom length and position of the Aire-Cuf.
Outcome	Resolution of obstructive granulation tissue and ulceration causing recurrent acute respiratory failure. Stabilization allowed discharge on home-appropriate ventilator after a 3-y hospitalization	Resolution of obstructive granulation tissue causing recurrent acute respiratory failure	Resolution of obstructive granulation tissue, ulceration, and hypercarbia. Stabilization allowed discharge on home-appropriate ventilator.

^aAll patients had chronic respiratory failure with long-term ventilatory requirements necessitating tracheostomy tube dependence.

^bTriplanar angulations define the point-defining angles for the custom tracheostomy tube angulations. All bends were contoured beyond the descriptions provided in a layered model of the airway to create a 3-dimensional product.