Complex Pediatric Airway Reconstruction, Swallowing and Tracheostomy

We are one of the nation’s few programs dedicated to caring for children with complex airway disorders and swallowing conditions. Our highly skilled experts partner with you to help your child feel better.

Doctor assessing child patient while mother holds her

Why choose the UCLA Complex Pediatric Airway Reconstruction, Swallowing and Tracheostomy Program?

Our program is one of the few in the nation dedicated to children with complex airway and swallowing disorders. Board-certified specialists in numerous fields collaborate to give your child comprehensive, 层次护理. 当你选择皇冠hga025大学洛杉矶分校健康中心时，你可以期待:

著名的卓越: 皇冠hga025大学洛杉矶分校健康's head and neck surgery program is widely known for its outstanding quality, regularly ranked among the nation's top programs by U.S. 皇冠hga025 & 世界报道. Numerous physicians from our program are also listed among Los Angeles Magazine's “前 Doctors” and “Super Doctors” in Southern California.

富有同情心的护理: We prioritize your child’s comfort and wellbeing, offering individualized support throughout their treatment journey.

的小方法: 你积极参与到孩子的照顾中, and we ensure that you are fully informed at every stage and work with you to develop a complete treatment plan.

专家团队: Our pediatric specialists work together to deliver comprehensive care. Our team includes specialists in otolaryngology (ear, 鼻子和喉咙), 肺科(呼吸系统), 胃肠病学(消化系统), speech-language pathology and respiratory therapy. Additional team members specializing in pediatrics include cardiothoracic (heart and chest) surgeons, 颅面外科医生, neonatologists (newborns with complex conditions), intensivists (critical care) and anesthesiologists (pain management during surgery).

研究重点: Our doctors are also active researchers who regularly publish their work about airway and swallowing care. That means your child has access to the latest treatments and innovations.

Complex pediatric airway and swallowing disorders we treat

呼吸, speaking and swallowing can be difficult when structures in a child’s respiratory system are diseased, 狭窄或阻塞. 这些结构包括:

咽(咽喉)
喉(喉部)
气管(气管)

Some children are born with airway and swallowing conditions (congenital). Others develop them from trauma, disease or prolonged use of a breathing tube.

Our team treats the most complex airway and swallowing conditions in children, including:

气道狭窄

气道狭窄 is narrowing of the airway, causing hoarseness or difficulty breathing. 气道狭窄 types depend on their location and include:

声门的狭窄: 声带处的喉部狭窄
声门下狭窄: 声带以下的喉部狭窄
气管狭窄: 气管变窄

其他气道状况

We treat all other airway conditions, including:

完整气管环: Cartilage rings in the trachea are usually “C”-shaped. Complete tracheal rings are “O”-shaped and smaller-than-normal, causing difficult, noisy breathing.
喉(气管)裂: An abnormal opening between the larynx and esophagus allows food and liquid to enter the lungs. 开口可能延伸到气管.
Laryngomalacia: Tissues above the vocal cords are soft and floppy, causing a partial airway obstruction. It’s the most common cause of noisy breathing (stridor) in infants.
喘鸣: Stridor is noisy breathing caused by 声带麻痹 or an obstruction or narrowing in the airway.
气管食管瘘: An abnormal connection between the esophagus and trachea allows food and liquids to reach the lungs.
Tracheostomy dependence and tracheostomy-related disorders: 在脖子上开了个口之后, doctors insert a tracheostomy tube in the trachea to help with breathing. Prolonged use of a tracheostomy tube for ventilation can cause various complications.

Voice-related条件

Voice disorders can stem from many causes, such as:

复杂的声音障碍: Conditions causing complex voice disorders include nodules, 声带麻痹, 囊肿, 肌肉张力失衡, 息肉, 结疤和慢性喉炎.
声门的分离: An abnormal gap between the vocal cords can cause voice problems.
复发性呼吸道乳头状瘤病: The human papillomavirus (HPV) causes benign wart-like growths on or near the vocal cords, 导致声音嘶哑或其他声音变化. Large growths may also make breathing difficult. The growths may return after they are removed because the virus remains in the tissue.
声带麻痹: The vocal folds, also known as vocal cords, don’t move, affecting breathing and speaking.

吞咽障碍

Common swallowing disorders in children include:

环咽的失弛缓性: The muscle at the top of the esophagus (food tube) doesn’t relax, making swallowing difficult.
吞咽困难和误吸: Dysphagia is the medical term we use when a child has trouble swallowing. Swallowing difficulties can cause food and liquid to enter the windpipe and lungs (aspiration).

我们提供的测试和程序

Your child’s doctor may refer you to a pediatric ear, 鼻喉科医生(耳鼻喉科医生). Pediatric otolaryngologists have specialized training in children’s airway and swallowing conditions. They work with other pediatric specialists and you to develop an effective treatment plan for your child.

Diagnosing complex pediatric airway and swallowing disorders

Our providers use several tests to diagnose airway and swallowing problems in children, including:

实验室测试

Your child’s doctor may request samples of blood, urine or tissues to analyze in a lab. 信息 from lab tests can provide valuable health insights.

成像

Your doctor may request detailed pictures of your child’s airways, lungs and blood vessels. 常见的影像学检查包括:

胸部x光片: This technique uses electromagnetic radiation to capture images of the inside of your child’s chest.
计算机断层扫描(CT): 通过x射线和计算机的结合, this scan produces detailed images of your child’s respiratory system.
磁共振成像(MRI): 使用无线电波, 大功率磁铁和电脑, this test creates detailed images of your child’s airway structures.
食管造影(钡餐研究): 你的孩子吞下了含钡的溶液, which coats the esophagus as it moves down to the stomach. Barium helps your doctor observe your child’s esophagus in action during a specialized X-ray called fluoroscopy.
改良钡餐研究: Similar to a barium swallow, this test checks to see if food or liquids enter your child’s lungs.

内窥镜成像检查

We insert a flexible or rigid tube with a light and camera at the end (endoscope) through the nose or mouth to view portions of your child’s airway. Specialized endoscopic tests we perform in our office include:

喉镜检查: 观察喉部
Flexible (fiberoptic) endoscopic evaluation of swallowing: A laryngoscopy that focuses on the swallowing process
支气管镜检查: 看气管
食管镜测法: 评估食道
内镜活检: 将组织样本送到实验室进行分析
三重内窥镜检查: 评估气道, lungs and upper gastrointestinal tract in a single endoscopic procedure in the hospital

Treating complex airway conditions and swallowing disorders

Most airway treatments aim to widen the airway and remove obstructions to make breathing easier. Depending on your child’s specific diagnosis and needs, their airway treatment may include oral medications, 注射, 手术或两者结合. 我们提供:

Nonsurgical treatments for complex pediatric airway conditions

Medications can help treat some airway conditions. Your child’s doctor may also recommend injecting steroids into the airway structures to reduce inflammation.

Endoscopic treatment for complex pediatric airway conditions

When possible, our doctors use minimally invasive procedures, including:

膨胀: This procedure stretches and opens the airway by temporarily inflating and then removing a small balloon.
支架: Your child’s doctor inserts a metal or silicone tube-shaped device to keep the airway open.
消融治疗: Your child’s doctor uses lasers to destroy scar tissue or tumors in the airway. This method usually offers a faster recovery time than traditional surgery.

Open surgical procedures to treat complex pediatric airway conditions

Some procedures require open surgery, which involves a skin incision to access the airway. We offer all complex airway surgical procedures for the larynx and trachea.

喉

我们的喉部手术包括:

Epiglottopexy: This procedure treats sleep and airway problems in children. Your child’s doctor secures the floppy epiglottis (tissue that covers the windpipe while eating) to the tongue to open the airway.
喉裂修复: This procedure involves using endoscopic or open surgical techniques to manage laryngeal clefts.
喉神经移植: This procedure restores nerve connections in the larynx, helping the vocal cords function.
Laryngotracheal reconstruction (laryngotracheoplasty): This procedure treats congenital or acquired airway stenosis. The doctor removes a small piece of cartilage from elsewhere in your child’s body (a graft). Then they insert the graft in the windpipe to widen it and make breathing easier.
Supraglottoplasty: 这种方法治疗喉软化. Your child’s doctor uses specialized lasers on the tip of an endoscope to reshape or remove excess tissue in the voice box.

气管

We also perform complex trachea surgeries, such as:

环气管及气管切除术: 该手术治疗晚期气道狭窄. Your child’s doctor removes the narrowed portion of the airway and reconnects the healthy sections.
幻灯片气管成形术: This procedure treats a severe type of stenosis called long-segment tracheal stenosis. Children with this condition often also have a heart abnormality. An ENT surgeon increases the trachea’s width for improved airflow, while a cardiac surgeon fixes the heart problem.
气管食管瘘修补术: Your child’s doctor separates the trachea and esophagus and closes the openings in each passageway.
气管造口术: Your child’s doctor makes an opening in the trachea to insert a tracheostomy tube. The tracheostomy tube helps your child breathe if they have an airway disorder.
气管造口术拔管: This is the process of removing a tracheostomy tube.

认识我们的团队

Our otolaryngologists are highly trained specialists in complex pediatric airway problems and swallowing disorders. They work closely with other pediatric specialists to manage your child’s condition and improve their quality of life.