Rotsides Janine M, Krakovsky Gina M, Pillai Dinesh K, Sehgal Sona, Collins Maura E, Noelke Carolyn E, Bauman Nancy M
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.
Ann Otol Rhinol Laryngol. 2017 Jul;126(7):537-543. doi: 10.1177/0003489417708579. Epub 2017 May 5.
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.
Isr Med Assoc J. 2021-9
Otolaryngol Head Neck Surg. 2015-7
JAMA Otolaryngol Head Neck Surg. 2015-2
Ann Otol Rhinol Laryngol. 2017-5
JAMA Otolaryngol Head Neck Surg. 2013-9
Laryngoscope. 2019-3-27
Int J Pediatr Otorhinolaryngol. 2019-1
Laryngoscope Investig Otolaryngol. 2022-3-23
J Otolaryngol Head Neck Surg. 2022-4-15
Children (Basel). 2021-6-23
Curr Treat Options Pediatr. 2018-12
Mol Genet Genomic Med. 2019-3