Comprehensive care for complex airway and upper digestive tract disorders
Aerodigestive disorders include a wide variety of chronic respiratory concerns with underlying gastrointestinal issues.
The Aerodigestive Disorders Program at C.S. Mott Children’s Hospital offers a multidisciplinary approach to aerodigestive care, combining specialists in pediatric otolaryngology (ENT), pediatric gastroenterology, pediatric surgery, pediatric pulmonology and speech-language pathology to provide comprehensive care. Our program was designed to provide truly specialized care exclusively for children with aerodigestive disorders - from providing an accurate diagnosis to creating individualized treatment plans for each child - with a focus on supporting your family each step of the way. Rather than individual specialists treating individual symptoms, your care will be coordinated across our team to ensure continuity of care and communication with you throughout your journey.
What are aerodigestive disorders?
Our Aerodigestive Disorders Program specializes in the treatment of complex breathing and swallowing disorders of the aerodigestive tract (nose, mouth, throat, lungs, esophagus and stomach), including:
Upper Airway Disorders
- Craniofacial syndromes causing breathing and feeding problems
- Laryngeal cleft
- Laryngeal web
- Laryngeal stenosis
- Severe laryngomalacia
- Vocal fold paralysis
- Caustic ingestion
- Colonic interposition
- Eosinophilic Esophagitis (EoE)
- Esophageal atresia
- Esophageal diverticuli
- Esophageal duplication
- Esophageal dysmotility disorders
- Esophageal strictures
- Esophageal webs
- Gastroesophageal Reflux Disease (GERD)
- Tracheoesophageal Fistula (TEF)
Aerodigestive disorder symptoms
Many symptoms can indicate an aerodigestive disorder, including:
- Choking episodes
- Chronic cough
- Dysphagia (difficult or painful swallowing)
- Failure to thrive
- Frequent vomiting or food regurgitation
- High-pitched noisy breathing
- Recurrent croup
- Recurrent respiratory infections
- Reflux affecting the airway
- Resistant asthma
Diagnosing aerodigestive disorders
Accurate diagnosis is the first step to an effective plan of care. Our aerodigestive specialists use a wide array of state-of-the-art tools to make accurate diagnoses:
- Fiberoptic endoscopic evaluation of swallowing (FEES)
- Video swallow study
- Pulmonary function testing (PFT), including endoscopic-assisted PFT and exercise-induced PFT
- Airway fluoroscopy
- Upper gastrointestinal tract (Upper GI) x-ray
- Chest x-ray
- CT scan of neck and/or chest
Treatment for aerodigestive conditions
The C.S. Mott Children’s Hospital team is committed to supporting both the short and long-term medical needs of our patients.
Your child’s care team will first review available medical therapies to determine if alternative medical treatment or modifications of the current treatment would be appropriate.
For those children whose conditions aren’t well managed through medication alone, we offer expertise in a full range of procedural and surgical techniques to give patients the most up-to-date and effective options for resolving their aerodigestive conditions.
Surgical techniques that may be recommended include laser surgery, minimally invasive techniques using endoscopic balloon dilation, and cartilage and mucosal grafting .
Other procedures that we offer include:
- Laryngoscopy to visualize the throat and voice box.
- Bronchoscopy to examine the airway within the lungs.
- Esophagogastroduodenoscopy with biopsies and/or dilation used to examine the esophagus, stomach, and duodenum for signs of infection, inflammation, or narrowing.
- Endoscopic laryngotracheal cleft repair, a procedure used to fix a cleft between the esophagus and trachea.
- Treatment of laryngeal webs and stenosis using microscopic instruments as well as the laser to restore normal anatomy and function.
- Vocal cord medialization, a procedure in which the paralyzed vocal cord is advanced to the middle so that the functioning vocal cords can close as necessary for normal voice and swallowing.
- Vocal cord reinnervation, an innovative procedure for vocal cord paralysis in which the surgeon takes a branch of the ansa cervicalis, a motor nerve in the neck, and sews it to the recurrent laryngeal nerve. The nerve graft gives the vocal cord tone and can improve vocal quality and swallowing in children with a paralyzed vocal cord.
- Nissen fundoplication, a procedure used to treat severe gastroesophageal reflux to stop the acid going up the esophagus as easily.
- Gastrostomy tube placement enables nutrition to be delivered directly to the stomach.
Rehabilitation and support: Your child will have access to our specialized pediatric social work team and child life therapists to understand and cope with anxiety related to his or her condition and treatment. We also coordinate with our audiology and speech-language pathology team to provide integrated support for children with speech, language and swallowing/feeding disorders.
What to expect at your first appointment
Prior to your visit, you will receive a phone call from our clinic to discuss your child’s medical records, including any imaging studies, treatments or procedures that may have already been performed. Our team will then be able to review your child’s records prior to your scheduled visit.
If your child has difficulty with a particular type of food, we request you bring a sample of the food and your child’s preferred utensils to your clinic appointment. If possible, it is often helpful if your child is hungry so we may observe him or her eating at the appointment. During your visit, you will have the opportunity to meet our entire team of subspecialists, who will ask additional questions, examine your child and develop a comprehensive care plan that may include additional tests or treatments.
Take the next step:
Schedule an appointment by calling us at 734-936-5730.