Aerodigestive Center tests, treatments, and services

Upper airway evaluation

Our team will perform an evaluation of your child's upper airway in instances where an airway obstruction is suspected. Upper airway evaluations can also help diagnose problems with the vocal folds problems that may relate to feeding or breathing issues.

Our team uses a number of diagnostic imaging tools to determine your child's specific condition. These tools are used in conjunction with a physical examination provided by one of our airway experts.

Laryngoscopy

This tool has proven valuable to our team in getting a closer look at the structures of the upper airway in the office. A small flexible tube with a tiny camera is used to look inside the nose and back of the throat. Technicians can also see in real time the movements to the vocal folds. With this information, the team can make recommendations for further treatment.

Upper airway treatments

A number of effective treatments for upper airway conditions are in regular use at Children's These include:

• Pediatric phonosurgery - to correct conditions of the vocal folds
• Airway tumor resection - to remove any obstructive tumors in the airway
• Laryngoplasty - surgically treats paralyzed or poorly functioning vocal folds
• Surgery for airway obstructions - by removal of tissue blocking the airway
• Vocal fold injections - to treat damaged vocal folds
• Non-surgical sleep apnea treatments - including sleep therapy and special sleeping masks

About lower airway evaluation

Our team commonly begins your child's lower airway evaluation with a flexible and/or rigid bronchoscopy. This minimally invasive procedure allows our team to get a closer look at your child's lower airway passages. If appropriate, a bronchoalveolar lavage may be performed to collect samples of mucus and cells from your child’s lower airway.

About feeding and swallowing evaluation

Feeding issues are generally related to the inability or impaired ability of your child to swallow properly. In order to diagnose the specific feeding and/or swallowing problem affecting your child, we use a number of diagnostic tests. These tests include:

• Clinical feeding evaluation. During this evaluation, a speech language pathologist observes your child feeding and swallowing various textures. This is completed in a clinical setting. 
• Fiber optic endoscopic evaluation of swallowing. In this procedure, a small tube is inserted into your child's nose. On the end of the tube is a small camera. Once the camera is in place, your child will be given items to eat or drink. While your child ingests the items, our specialist can see, in real time, exactly how your child's swallowing muscles function.
• Video fluoroscopy swallow study. This test uses x-ray images of your child swallowing to get a better understanding of underlying swallowing conditions.

Feeding and swallowing treatments

Once a determination has been made as to the cause of your child's feeding issue, whether it is swallowing related or not, our team will prescribe a course of treatment. Treatment might involve a feeding team consultation.

About digestive evaluation

Our team has many techniques available to evaluate your child's digestive system.

• Esophagogastroduodenoscopy (EGD). In this minimally invasive procedure, a flexible endoscopic tube is placed into your child's mouth. The tube, fitted with a camera, is capable of reaching all parts of the upper gastrointestinal tract. The tool is useful for the diagnosis of ulcers, tumors and esophageal obstructions, among other conditions.
• Manometry. This procedure studies the levels of pressure inside your child's digestive system, usually the esophagus. This information is critical to understanding some underlying causes of nausea, indigestion and other digestive issues.
• pH impedence. This test looks at how fluids and food move in your child’s esophagus. Your esophagus is the
  tube that moves food from your mouth to your stomach. The test also shows if air or acid reflux is in the esophagus. Reflux is caused by stomach contents coming up into the esophagus.
• Esophagram. Your child will drink thick flavored liquid called barium. A large camera will take x-rays of your child as they drink the barium. The camera can see the barium inside the esophagus. A doctor who specializes in taking and reading x-rays will watch the picture on a TV screen. This doctor is called a radiologist. The test will not hurt your child. Most often, the test takes about 30 minutes. When it is done, the doctor will check the x-rays while you wait.