Pediatric Aerodigestive Center at Dell's Children
What is the Aerodigestive Center?
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Conditions we diagnose and treat
- Airway stenosis (narrowing of the trachea "windpipe")
- Aspiration (when food or liquid enters the airway)
- Dysphagia (swallowing difficulty)
- Eosinophilic esophagitis (EoE) (chronic inflammation of the esophagus, thought to be an immune reaction to various triggers)
- Esophageal stricture (abnormal narrowing of the esophageal lumen)
- Feeding and respiratory disorders
- Gastrointestinal disorders (gastroesophageal reflux, constipation etc.)
- Gastrointestinal motility disorders associated with breathing and feeding difficulties
- Laryngeal cleft (malformation involving the larynx and esophagus)
- Laryngomalacia (soft/floppy larynx or upper airway)
- Tracheoesophageal fistula (malformation involving the trachea and esophagus)
- Tracheomalacia (when the windpipe is floppy or abnormally collapsible)
- Tracheobronchomalacia (when distal airways/bronchial tubes are floppy or abnormally collapsible)
- Vocal cord paralysis (occurs when the nerve impulse to your voice box are disrupted, resulting in paresis or immobility of the vocal cord. This can affect your ability to speak and even breathe)
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Our procedures
- Diagnostic and therapeutic endoscopy (Rigid Microlaryngoscopy, Rigid/Flexible Bronchsocopy, Esophagogastroduodenoscopy)
- Esophageal pH and impedance probes
- Esophageal Manometry
- Endoscopic airway reconstruction
- Complex open airway reconstruction
- Endoscopic voice evaluation
- Functional Endoscopic Evaluation of Swallowing (FEES)
- Modified Barium Swallow Study (MBSS)
- Polysomnogram (Sleep Study)
- Drug Induced Sleep Endoscopy
Caring for the whole child
Prior to your first visit you can expect an intake call from our nurse coordinator. During your child’s appointment, the Aerodigestive team assesses the patient and develops a plan of care. This can include medications, treatments, feeding plans, therapies, diagnostic procedures and/or surgical procedures - all of which are discussed with the patient’s parents/guardians. Due to the nature of our multidisciplinary clinic, it is best to plan for a longer appointment window to accommodate comprehensive assessments.
Our nurse coordinator is the main point of contact following the clinic visit and will assist with scheduling any outstanding procedures. Communication with the team is welcome between clinic visits as fluid communication is key to the coordination and implementation of the child’s individual and comprehensive treatment plan. Bi-monthly team meetings for providers are also held to discuss overall patient findings, new needs and ongoing plans. Follow up visits are traditionally quarterly, bi-annually or annually, depending on the needs of the child.
Advantages to our multidisciplinary approach
- Scheduling of a combined appointment at one location to see all doctors and care providers, which allows for the development of a collaborative treatment plan.
- Coordination of surgical procedures to limit anesthetic exposure for children and allow for comprehensive evaluation.
- Continuity of care throughout the entire length of treatment with ongoing support from the clinical team in between clinic appointments.
The Tube Wean Program
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Program criteria
Children who currently utilize a feeding tube as their source of nutrition and meet the following criteria:
- Has the ability to safely swallow at least 1 or 2 textures
- Demonstrates some skill and interest in eating by mouth
- Is motivated and interested in weaning off enteral feedings
- Has family support to wean off enteral feedings
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Our multidisciplinary approachWe work with you and your child to optimize schedules, nutrition, feeding strategy and parent coaching to help your child develop trust in their ability to eat and willingness to try new foods. Through the use of hunger and strategy, children can learn to trust hunger and regulate their bodies nutritional needs. Initial weight loss or lack of weight gained is expected as your child learns to become a happy, healthy oral eater. Close monitoring ensures your child stays on their growth curve during this transition.
Meet our care team
Stacey Clark, MD
Pediatric Otolaryngology, Medical Director of Aerodigestive Center
James Attra, MD, FAAP
Pediatric Otolaryngology
Danielle Yarbrough, MD
Pediatric Otolaryngology
June-Ku Brian Kang, MD
Pediatric Pulmonology
Ferdinand Coste, DO
Pediatric Pulmonology
Chantal Lucia-Casadonte, MD
Pediatric Gastroenterology
Anees Siddiqui, MD
Pediatric Gastroenterology
E. April Jones, CPNP
Pediatric Gastroenterology
Emily Ruscitto, PA-C
Aerodigestive Advanced Practice Provider, Pediatric Otolaryngology
Melissa Jouflas, BSN, RN
Pediatric Nurse, Aerodigestive Nurse Coordinator
Ashley Kaspar, MS CCC-SLP
Pediatric Speech Language Pathologist
Emily Rasco, OTR
Pediatric Occupational Therapist
Aimee Ledoux, RRT
Respiratory Therapist
Leslie Bracken, RD
Registered Dietitian
Katie Rowe, RD
Registered Dietitian