Aerodigestive Program
The Aerodigestive Program at Children’s Hospital Los Angeles is the first and only multidisciplinary clinic addressing the needs of children with complex breathing and feeding disorders in the Southern California region. Aerodigestive disorders include a variety of conditions which affect the respiratory and digestive systems which may include the mouth, nose, throat, lungs and/or esophagus. Affected children may have various problems including difficulty swallowing, shortness of breath and chronic cough.
Children visiting our program are seen in their initial visit to our clinic by specialists from Otolaryngology/ENT, Pulmonary, Gastroenterology and General Pediatric Surgery and together we develop a comprehensive plan of care. Patients will also be evaluated and seen by Anesthesiology, Speech and Language Pathology, feeding therapy and registered dietitian as needed on the same day. Referrals to other specialty services are also organized as needed.
Comprehensive Care
The Aerodigestive program provides an organized, coordinated and efficient means of diagnosing and treating children with breathing or feeding problems who may otherwise be left with multiple appointments and visits to different specialists which can take a lot of time and be stressful for children and their families. Our goal is to streamline this process and provide children and their families with answers and a definitive plan to address their needs.
Clinical Trials and Research
As a means of ensuring continuing excellence and state of the art patient care, the Aerodigestive Program at CHLA conducts prospective outcomes research. This is important in making improvements in care to patients seen in our program and other programs. Patients evaluated in our clinic may be consented for participation in this research. Patient information is always protected and confidential and the study is approved by the CHLA Institutional Review Board.
Commonly Treated Disorders
- Congenital abnormalities of the airway and esophagus
- Tracheo-esophageal fistula with or without esophageal atresia
- Laryngomalacia, Tracheomalacia, Bronchomalacia
- Laryngo-tracheoesophageal cleft (LTEC)
- Secondary tracheomalacia or bronchomalacia secondary to other diagnosis (e.g. Vascular ring etc..)
- Subglottic Stenosis (primary or secondary)
- Stridor, noisy breathing
- Vocal cord dysfunction/paralysis
- Recurrent croup
- Aspiration pneumonia, Recurrent pneumonia
- Chronic cough
- Some of the craniofacial patients with multiple comorbidities
- Medically complex thoracic diseases requiring multidisciplinary care
- Eosinophilic Gastrointestinal diseases (EGIDs)
- Gastro esophageal reflux with persistent symptoms
- Feeding disorders
- G tube or NG tube dependency
- Intestinal failure
- Oral aversions: sensory & or texture issues
- “Picky eaters”
- Dysphagia (swallow dysfunction)
What to expect during your first visit
Families coming to their first Aerodigestive Clinic should plan on being in the clinic for approximately 2 hours. You will meet with specialists from Otolaryngology, Pulmonary and Gastroenterology whom will discuss with you the problems and concerns your child is having and examine your child. You will also meet with the General Pediatric Surgery team if needed. We each bring a different perspective to this assessment and we will then discuss your childs case and coordinate a diagnostic plan. This may include additional tests such as laboratory studies, X-rays, Pulmonary function tests, or swallow studies. In some cases, additional tests may be performed that same day.
For many patients evaluated in our clinic, we will recommend a direct assessment of the entire upper aerodigestive tract in the operating room including a direct laryngoscopy and bronchoscopy by otolaryngology, a flexible bronchoscopy with bronchoalveolar lavage by Pulmonary and an esophagogastroduodenoscopy (EGD) with biopsies by gastroenterology. This combined evaluation, referred to as a “triple scope” is coordinated and performed on a different day by the same three physicians, which you will meet in the Aerodigestive Clinic, and can provide essential diagnostic information about what is causing the problems your child is experiencing.
