The Evolving Management of Children with Complex Airway and Swallowing Disorders

Author: Shyan Vijayasekaran

Vijayasekaran, Shyan, 2024 The Evolving Management of Children with Complex Airway and Swallowing Disorders, Flinders University, College of Medicine and Public Health

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Abstract

Summary

Stridor, stertor, snoring, feeding difficulty and obstructed breathing are common presentations to neonatologists, paediatricians, respiratory physicians, and general practitioners. Typically, affected patients are referred to a paediatric otolaryngologist for evaluation and treatment. A wide range of pathology affecting the nose to the bronchi causes obstructed breathing and feeding difficulties, and the assessment and treatment of these conditions are constantly evolving. In this thesis, my aim has been to collate the body of relevant academic work that I have undertaken. It is my hope that I have contributed to ongoing changes aimed at improving treatment algorithms and increasingly achieving positive outcomes.

Methods

This thesis is a compilation of 37 publications spanning over 17 years (2006 to 2023). The 11 chapters include peer reviewed articles, book chapters, and video journal publications that focus on a variety of upper aerodigestive tract pathologies in the child. The publications include histopathological studies of the larynx, animal studies, case series, novel surgical techniques, assessment of surgical outcomes, international consensus documents, literature reviews, and book chapters.

Conclusion

Although the breadth of the publications is wide, they reflect a number of common themes, including principles of treatment and early diagnosis of infants and children with complex aero-digestive problems, multidisciplinary management of these children, minimising adverse events, and continuous assessment of the outcomes. Many of the interventions described in these publications remain the only publications from Australian and New Zealand institutions on these topics.

Keywords: Aerodigestive disorders, Stridor, Snoring, stertor, airway obstruction, drooling, aspiration, dysphonia, sleep apnoea, dysphagia, tracheostomy, laryngotracheal reconstruction, Piriform aperture stenosis, choanal atresia, laryngomalacia, subglottic stenosis, tongue base surgery, supraglottoplasty, laryngeal web, laryngeal cleft, tracheo-oesophageal fistula, tracheal stenosis, CICO

Subject: Medicine thesis

Thesis type: Doctor of Philosophy
Completed: 2024
School: College of Medicine and Public Health
Supervisor: Eng Ooi