Stanford Center for Excellence in Pulmonary Biology

Aerodigestive Program

Aerodigestive Program: Overview

The Aerodigestive Center’s Family-Centered Model reduces the burden on patients and their families when juggling multiple clinic visits, diagnostic studies, and procedures that are often required in the management of complex airway and esophageal disease.

When patients are referred to the Aerodigestive Program, they are contacted by a caring and personable scheduler, interviewed by a specialized nurse practitioner, and given a clinic appointment where all providers see the patient during the same visit. Many patients will undergo diagnostic endoscopic procedures involving all necessary healthcare providers under one anesthetic session.  This evaluation is scheduled based on the family’s availability and can occur as soon as the day following the clinic visit.  This care model enhances communication between practitioners, ensures that the patient receives a clear and concise message about their diagnosis, and minimizes repeated anesthetics and procedures. Specialists then provide a team consensus, including a working diagnosis, an explanation of care options, and a comprehensive and organized treatment plan. Our approach also has the ability to reduce the overall procedural costs, and increases the precision, efficiency, and quality of care that the child receives. Other benefits include reducing time off from work and school for patients and their families. More 

The Aerodigestive Program provides:

  • Assistance from a caring and personable scheduler.
  • A pre-visit phone interview with a specialized nurse practitioner
  • A complete review of medical records.
  • Comprehensive same-day visits in one clinic space with experts from fields including otolaryngology, head and neck surgery, pulmonary medicine, gastroenterology, pediatric surgery, and speech language pathology.
  • If needed, diagnostic testing, including swallow studies, breathing evaluations, chest imaging, laboratory tests and sleep studies (polysomnograms).
  • Coordinated medical procedures that minimize the need for multiple sedation and anesthetic exposures.
  • A team consensus that features a working diagnosis, an explanation of treatment options and a comprehensive and organized treatment plan.
  • Consultations with other services such as social workers and nutritionists, available if needed.
  • An approach that has the ability to reduce overall procedural costs, increase the precision, efficiency, and quality of care, and minimize time off from work and school for patients and their family.

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Conditions We Treat:

Our aerodigestive team provides coordinated care for a range of complex conditions, including:

Disorders of the Larynx and Trachea

  • Airway obstruction
  • Dysphonia and complex pediatric voice disorders
  • Laryngeal cleft 
  • Laryngeal paralysis  
  • Laryngeal stenosis
  • Laryngeal web
  • Laryngeal and tracheal inflammation
  • Laryngeal spasm
  • Posterior glottic diastasis
  • Recurrent croup
  • Severe laryngomalacia
  • Subglottic stenosis
  • Tracheal stenosis
  • Tracheomalacia
  • Tracheoesophageal fistula (TEF)
  • Tracheostomy dependence or malfunction
  • Vocal cord cysts, nodules and polyps
  • Vocal cord paralysis
  • Voice abnormalities following airway reconstruction
  • Voice abnormalities resulting from laryngeal injury

Pulmonary Disorders

  • Bronchiectasis
  • Bronchomalacia
  • Chronic cough
  • Interstitial lung disease
  • Obstructive apnea
  • Pulmonary aspiration
  • Recurrent wheezing
  • Recurrent pneumonia
  • Recurrent respiratory infections
  • Refractory asthma

 

Esophageal, Gastrointestinal and Swallowing Disorders

  • Achalasia
  • Aspiration and swallowing dysfunction
  • Caustic ingestion
  • Complex feeding disorders resulting from anatomic and physiologic abnormalities
  • Diseases of the salivary glands
  • Dysphagia and complex swallowing disorders
  • Eosinophilic esophagitis (EoE)
  • Esophageal atresia
  • Esophageal strictures
  • Esophageal webs
  • Gastroesophageal reflux disease (GERD)
  • Sialorrhea
  • Tracheoesophageal fistula (TEF)

Meet Our Care Team

The Aerodigestive Program is comprised of providers from multidisplinaries who are dedicated to the health of children with special needs:

  • Pediatric Pulmonologist 
  • Pediatric Otolaryngology Head and Neck Surgeons    
  • Pediatric Gastroenterologist
  • Pediatric Surgeons
  • Speech and Language Pathologist
  • Advanced License Clinical Social Worker
  • Registered Dietician


     

Our Services

The multidisplinary Aerodigestive Program provides the following services:

  • Comprehensive evaluation to determine what’s causing the breathing difficulty and map out a treatment plan.
  • Lung function testing (See link below)
  • Sleep studies to assess and help improve sleep quality (See link below)
  • Airway clearance treatment training and follow-up care
  • Nutrition Counseling
  • Assisted Ventilation
  • Bronchoscopy (Airway examination)
  • Lung imaging

Contact Us to Make an Appointment

To Make an appointment:

Call: 650-498-2730

Fax: 650-498-2734

Locations:

Stanford Children's Health Aerodigestive Clinic:

730 Welch Road, 1st Floor

Palo Alto, CA, 94304

 






Physician Team Leaders

Clinical Associate Professor, Pediatrics - Pulmonary Medicine

My My Buu, MD

Dr. MyMy Buu is a board certified pediatric pulmonologist and specializes in the evaluation and treatment of pediatric lung diseases including chronic respiratory failure and neuromuscular weakness. She has practiced pediatrics and pediatric pulmonary for more than 10 years.  She is skilled in airway examination with flexible bronchoscopy

Dr. Buu is dedicated to caring for children with chronic disease and special health care needs. She has extensive experience working in multidisciplinary care teams.  She is the Pediatric Pulmonary Team Leader for the Aerodigestive Program and Neuromuscular Disorders Program and.  Her scholarly work has been focused on pediatric health in vulnerable communities.

Clinical Associate Professor, Pediatrics - Pulmonary Medicine

Esmeralda Morales, MD

Esmeralda Morales, MD is a Board-Certified Pediatric Pulmonologist who earned her medical degree from Baylor College of Medicine.  She completed her subspecialty training in Pediatric Pulmonology at the University of Arizona/Arizona Respiratory Center known for its excellence in asthma care and research.  She practiced in the southwestern United States for 7 years including a year as Interim Chief of the Pediatric Pulmonary Division at the University of New Mexico and was a former New Mexico Cystic Fibrosis Center Director, prior to joining the Lucile Packard Children’s Hospital (LPCH) Stanford group.  She has experience evaluating and treating a wide variety of pediatric lung disease including:  chronic/recurrent cough or wheezing, asthma, pneumonia, apnea, neuromuscular disease, chronic lung disease, chronic respiratory failure and interstitial lung disease.  Her main area of interest is in aerodigestive disorders in children, and she is a member of the pediatric aerodigestive care team at LPCH Stanford.

Associate Professor of Otolaryngology - Head & Neck Surgery (OHNS) and, by courtesy, of Pediatrics

Douglas Sidell, MD

Dr. Sidell is Assistant Professor of Otolaryngology -Head and Neck Surgery at the Stanford University Medical Center, where he is a member of the Division of Pediatric Otolaryngology. Dr. Sidell's surgical practice focuses on the management of children with complex airway and pulmonary disorders, with a special interest in complex and revision airway reconstruction. His clinical interests also include the management of children with voice and swallowing disorders as well as congenital or acquired abnormalities of the larynx and trachea. He is the Director of the Pediatric Aerodigestive Center and the Pediatric Voice and Swallowing Clinics at Lucile Packard Children's Hospital Stanford.