About airway abnormalities
In children, airway abnormalities are usually congenital, or present from birth. Some might be due to trauma or related to medical treatment for another disorder. These abnormalities can affect the trachea, the larynx (voice box) or any of the passageways that lead to the lungs. Often, children can experience breathing problems or coughing as a result of airway issues.
Airway abnormality care
Because Children’s Hospital of Wisconsin specializes in the treatment of kids, our team has first-hand expertise in the most common causes of airway abnormalities: congenital conditions. In order to diagnose and treat your child, our team will employ a wide range of technological and human know-how. Your child will likely undergo an airway evaluation, which might include a test using a flexible larynogscopy (a tool to look at the voice box). After all diagnostic tests are complete, our team will consult with you about the best possible course of treatment for your child.
About airway obstruction
Sometimes, airway obstruction presents itself as an emergency situation that requires immediate care. Other times, the airway might be only partially obstructed. Obstructions can be caused by trauma, accidental swallowing, or congenital conditions. In many cases, airway obstructions lead to sleep apnea in children.
Airway obstruction care
In addition to the resources of the nation’s leading pediatric trauma center at Children’s, the airway team uses the latest diagnostic tools to evaluate chronic airway obstructions. In some cases, surgery might be necessary to correct obstructions. Sometimes, treatment can come in the form of respiratory therapy or other non-invasive means.
About airway neoplasms
Many conditions contribute to airway discomfort. After evaluation, our team might diagnose your child with an airway neoplasm. Airway neoplasms are rare tumors that form in the soft lining of the airway. These tumors can be benign, pre-malignant or malignant.
Airway neoplasm care
Treatment for airway neoplasms depends on the severity of the case and the stage of a tumor or tumors. In most cases, our team will perform a resection, or surgical removal of the affected tissue.
About feeding issues
Feeding issues can arise if your child has difficulty swallowing (dysphagia), or has a condition, like esophageal disease. Most often, feeding issues affect the smallest infants who can’t suckle due to problems with the muscles of mouth, throat or esophagus. Feeding issues can lead to nourishment deficiencies, which can also be treated by the Children’s team.
Feeding issues care
Feeding problems can develop in all children, especially those who may be more medically-complex. At times, it is useful to visualize swallowing when young children have feeding problems. A fiberoptic endoscopic evaluation of swallow (FEES) study can be performed quickly and painlessly in the clinic, allowing specialists to assess the safety and mechanics of swallowing. Specialists may also recommend radiographic swallow studies and eventual referral to the interdisciplinary feeding clinic at Children's Hospital of Wisconsin.
Some babies are born with easily collapsible cartilage in the larynx. This cartilage can sometimes collapse inward when your child breaths in. You can often hear a high-pitched wheezing sound as a result. The wheezing is called stridor and laryngomalacia is one of the most common causes.
Most babies diagnosed with laryngomalacia at Children’s Hospital of Wisconsin are brought to our team to determine the cause of stridor. To diagnose laryngomalacia, a flexible laryngoscopy, or viewing of the voice box with a telescope, might be performed. This tool gives our team an up-close view of your child’s larynx. In 90% of laryngomalacia cases, your child’s larynx will strengthen on its own and the condition will go away. In other cases, surgery might be necessary to correct the problem.
About obstructive sleep apnea
Obstructive sleep apnea happens when your child stops breathing while he or she is asleep. When your child has sleep apnea, it might appear as though he or she is trying to breathe as the chest will rise and fall, however, no air actually reaches the lungs. Most often, enlarged tonsils or adenoids are to blame for the blockage. In rare instances, the blockage might be caused by narrowing of the airway passage or a tumor in the airway.
Obstructive sleep apnea care
Our team has years of experience in treating pediatric obstructive sleep apnea. If you or your doctor is concerned that your child might have this condition, our team will run a comprehensive diagnostic study, which might include an overnight sleep study, or flexible laryngoscopy. The most common treatment for children with obstructive sleep apnea is the surgical removal of the tonsils or adenoids. Other treatment options such as weight management and special sleeping devices are also available if necessary.
About persistent coughing or recurrent pneumonia
A persistent cough in a child might be a lingering symptom of a recent cold or flu. Sometimes the situation can signal a more complicated issue. Some persistent coughing episodes might be caused by airway abnormalities, obstructions or other airway conditions. In some children persistent coughing might be tied to recurrent pneumonia. Some children, less than ten percent, who have been hospitalized for pneumonia get a second or third bout of the disease later on.
Persistent coughing or recurrent pneumonia care
Some cases of persistent coughing are associated with recurrent pneumonia and some are not. In order to differentiate the cases, our team will conduct a thorough evaluation of your child’s airway. Using the latest imaging devices, in some cases an airway x-ray, we will be able to determine if there is an underlying airway condition that is contributing to the cough. The airway can also be examined with flexible laryngoscopy or bronchoscopy (examination of the lower airway under general anesthesia). Our team can treat the causes of persistent coughing with medications or surgery. If the coughing is related to recurrent pneumonia, our team will launch a personalized pneumonia treatment and prevention plan which might include medications, respiratory therapy and lifestyle changes.
About sialorrhea and aspiration
Saliva helps keep your child’s mouth lubricated and assists in the first stages of digestion. An overabundance of saliva, or sialorrhea, can cause a number of uncomfortable medical issues. When too much saliva is produced, your child may drool uncontrollably. In more complicated cases, the excess saliva can be breathed in, or aspirated, which can cause pneumonia.
Sialorrhea (drooling) and aspiration care
No single underlying condition causes the majority of sialorrhea cases. Some common causes, particularly in children, include allergic reactions, acid reflux disease and some types of pancreas and liver diseases. Other causes may be related to weak muscle tone or developmental delays. Our team will perform a full evaluation of your child to discover the underlying cause of sialorrhea and treat it immediately to make sure that the condition does not lead to pneumonia. Medications treat most instances of sialorrhea.
Stridor, or “noisy breathing” occurs when an obstruction in your child’s windpipe causes a wheezing sound when he or she breathes. The condition mostly affects the very young. In most instances, stridor is caused by laryngomalacia, a condition in which immature cartilage in the mouth falls into the airway during inhalation.
To discover the underlying cause of your child’s stridor, our team might perform an endoscopy of the airway. This procedure allows our team to get a better look at the structure of your child’s airway. If laryngomalacia is present, the problem will usually solve itself over time. For other underlying causes of stridor, medication or surgery might be prescribed.