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Is a Multidisciplinary Aerodigestive Clinic More Effective at Treating Recalcitrant Aerodigestive Complaints Than a Single Specialist?

作者信息

Rotsides Janine M, Krakovsky Gina M, Pillai Dinesh K, Sehgal Sona, Collins Maura E, Noelke Carolyn E, Bauman Nancy M

机构信息

1 George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

2 Department of Otolaryngology-Head and Neck Surgery, Children's National Health System, Washington, DC, USA.

出版信息

Ann Otol Rhinol Laryngol. 2017 Jul;126(7):537-543. doi: 10.1177/0003489417708579. Epub 2017 May 5.


DOI:10.1177/0003489417708579
PMID:28474959
Abstract

OBJECTIVE: To determine the utility of a pediatric multidisciplinary aerodigestive clinic (ADC) in treating recalcitrant aerodigestive conditions. METHODS: Longitudinal observational study of presenting complaints, evaluation, management, and outcome of patients seen during 12 monthly ADCs beginning August 2013. RESULTS: Fifty-five patients were seen by the ADC team (otolaryngology/gastroenterology/pulmonology/speech pathology/nurse practitioner) and followed for a mean 17.6 months (range, 12-26 months). Mean age was 4.3 years (range, 0.5-19 years). All were seen by at least 1 specialist before ADC referral but without significant improvement. Chronic cough was the most common primary symptom (44%). Clinic evaluation included flexible nasopharyngolaryngoscopy (FFL, 53%) and pulmonary function testing (36%.) FFL influenced management in 79%. An operative procedure usually combined endoscopy was warranted in 58%. Endoscopy provided high diagnostic yield, detecting laryngeal cleft (8), adenoid hypertrophy (8), vocal cord dysfunction (4), pulmonary infection (4), reflux disease (3), laryngomalacia (3), tracheomalacia (2), cilia abnormality (2), celiac disease (1), Helicobacter pylori (1), duodenal web (1), and eosinophilic esophagitis (1). Outcome was available for 48 of 55 patients, with 73% reporting resolved to markedly improved symptoms and 27% minimal to no improvement. CONCLUSIONS: The ADC team approach resulted in resolved to markedly improved symptoms in 73% of patients whose symptoms persisted despite seeing a single specialist prior to referral.

摘要

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[1]
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J Pediatr (Rio J). 2024

[2]
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J Pediatr (Rio J). 2023

[3]
Evaluation of aerodigestive disease and diagnosis of sliding hiatal hernia in brachycephalic and nonbrachycephalic dogs.

J Vet Intern Med. 2022-7

[4]
A multi-disciplinary approach to chronic cough in children.

Laryngoscope Investig Otolaryngol. 2022-3-23

[5]
Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada.

J Otolaryngol Head Neck Surg. 2022-4-15

[6]
Multidisciplinary aerodigestive program at a children's hospital: A protocol for a prospective observational study.

PLoS One. 2021

[7]
Development of a Multidisciplinary Aerodigestive Program: An Institutional Experience.

Children (Basel). 2021-6-23

[8]
Patient and Family Experience in a Multidisciplinary Clinic for Children With Single-Ventricle Heart Disease.

J Patient Exp. 2020-12

[9]
Aerodigestive Approach to Chronic Cough in Children.

Curr Treat Options Pediatr. 2018-12

[10]
A multidisciplinary approach to the clinical management of Prader-Willi syndrome.

Mol Genet Genomic Med. 2019-3

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