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Pediatric Aerodigestive Center Opens

A New Addition to the Komansky Center for Children's Health

NEW YORK (May 1, 2012)

The NewYork-Presbyterian Phyllis and David Komansky Center for Children's Health is pleased to announce the opening of its new Pediatric Aerodigestive Center, which provides diagnosis and treatment for children and adolescents with airway, breathing, and swallowing disorders. The multidisciplinary center, the only one of its kind in the New York area, brings together pediatric specialists in Gastroenterology, Pulmonology, and Otolaryngology (Ear, Nose and Throat), as well as and other subspecialties, including nutrition and speech pathology, to manage the medical and surgical care of children with a variety of aerodigestive disorders.

"We care for children who have complex medical issues that often overlap between respiratory and gastrointestinal problems," notes Anil Kesavan, M.D., a pediatric gastroenterologist, who works closely with Joshua P. Needleman, M.D., pediatric pulmonologist, and Vikash K. Modi, M.D., pediatric otolaryngologist.

The Pediatric Aerodigestive Center provides state-of-the-art diagnostic testing and treatment for children with:

  • Airway or voice disorders
  • Swallowing disorders
  • Sleep apnea
  • Gastroesophageal reflux disease (GERD)

The Pediatric Aerodigestive Center performs diagnostic and interventional endoscopic procedures in children of all ages with gastrointestinal diseases. These include esophagogastroduodenoscopy, ileoscopy, polypectomy, percutaneous gastrostomy tube placement, endoscopic management of upper gastrointestinal bleeding, and esophageal dilatation.

Different Specialists, Coordinated Same-Day Care

"A major benefit of having a designated Pediatric Aerodigestive Center is that we're able to consolidate care," says Dr. Kesavan, whose clinical expertise includes pediatric gastroenterology, hepatology, and nutrition. "Rather than parents having to see three different services on different days, our coordinator is able to schedule appointments or procedures that can all be completed on the same day. Everything happens more quickly and it is much easier for the parents and the patients."

"There are so many patients whose problems intersect across our specialties," says Dr. Needleman, who specializes in asthma, chronic lung disease, exercise physiology, cystic fibrosis, and pulmonary function testing. "We see patients of all ages with chronic cough, airway disorders, and feeding, swallowing, and reflux problems. At the Aerodigestive Center we identify patients who would benefit from a cohesive evaluation that often can be done in one day.

"Some of these patients need to have procedures such as endoscopy or bronchoscopy. Here they can have them done all at once with just one anesthesia. We look at the findings together, talk about them, and establish a plan for the patient that can be implemented right away."

Working Together - Looking at the Whole Patient

Dr. Needleman notes that many patients have multiple, chronic medical problems. "Their parents are experts at navigating medical systems. With the Aerodigestive Center they see how much easier it is to coordinate care for their child and they are very appreciative. And it's also easier for our physicians to give good medical care because we can see and discuss things together."

In one example, Dr. Kesavan describes their collaborative approach to care for patients with vomiting issues and chronic respiratory problems. "I might perform an upper endoscopy, a procedure that allows me to look at the esophagus, the stomach, and the first part of the small intestine," he says. "Dr. Needleman will do a bronchoscopy where he looks at the trachea and the bronchial airways. Dr. Modi and Dr. Robert Ward will do a laryngoscopy where they get a good look at the back of the posterior larynx and the upper part of the airway. We perform these procedures in sequence at the same time, one after the other."

The Center's pediatric otolaryngologists are pioneers in the areas of minimally invasive endoscopic airway surgery, as well as open laryngotracheal reconstruction. Says Dr. Modi, "The aerodigestive system is an intimately related area and it makes sense for pediatric pulmonologists, gastroenterologists, and otolaryngologists to collaborate to treat complex disorders that arise within the aerodigestive tract. Otolaryngologic conditions that require a team approach include subglottic stenosis, chronic aspiration, and chronic cough."

"At the Aerodigestive Center, we are able to take a step back and look at the whole picture," adds Dr. Kesavan. "It's helpful to talk with the other two services. Each physician looks at a particular disease from a different angle. Through this collaboration we are able to provide more thorough and better care for the children."

Contact the Pediatric Aerodigestive Center

To schedule an appointment or refer a patient, or for more information on the Pediatric Aerodigestive Center, please call the Division of Pediatric Pulmonology, Allergy and Immunology at (646) 962-3410.

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