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Dr. Balakrishnan is a pediatric otolaryngologist specializing in the care of children with complex disorders of breathing, voice, and swallowing. He is an expert in complex surgical reconstruction of the larynx (voice box) and trachea (windpipe); innovative approaches to pediatric airway reconstruction; and in vascular anomalies of the head and neck. He has interests in improving the quality, safety, and value of pediatric surgical care, reducing costs of care, and optimizing the patient, family, and caregiver healthcare experience. He also has expertise in how cognitive and implicit bias may affect medical decision-making and in healthcare disparities and injustice. Dr. Balakrishnan is also a committed educator. He was nominated for otolaryngology faculty Teacher of the Year at Mayo Clinic and has worked with Stanford residents to develop an innovative quality improvement education program for surgical trainees. He has mentored multiple fellows, residents, medical students, and undergraduates, several of whom have pursued careers in otolaryngology. He frequently works with international colleagues to provide otolaryngology education in multiple resource-limited settings as well.Dr. Balakrishnan has nationally and internationally recognized expertise in these areas, with many national and international invited presentations. He has published over 70 peer-reviewed papers, multiple textbook chapters, and a textbook (Evidence-Based Management of Head and Neck Vascular Anomalies, 2019). He has also served as Associate Editor for the journal Otolaryngology – Head and Neck Surgery and the Journal of Vascular Anomalies. He serves on multiple national and institutional quality committees and is founding co-chair of the national multicenter Aerodigestive Research Collaborative. His commitment to quality care for children and surgical patients has been recognized with fellowships in the American College of Surgeons and American Academy of Pediatrics. Dr. Balakrishnan was born and raised in Baltimore, Maryland and attended college at Harvard University. After taking a year to work as a high school teacher in Baltimore, he attended medical school at Johns Hopkins, with an additional year to complete a Howard Hughes Medical Institute research fellowship. He then completed residency in Otolaryngology – Head & Neck Surgery at the University of Washington. During residency, Dr. Balakrishnan completed a two-year NIH-funded research fellowship and a Master of Public Health degree with a focus on Health Services. He then completed a two-year fellowship at Cincinnati Children’s Hospital with a focus on complex reconstruction of the pediatric larynx and trachea and pediatric aerodigestive disorders. In 2014, Dr. Balakrishnan joined the otolaryngology faculty at Mayo Clinic in Rochester, Minnesota, where he had a busy pediatric airway and aerodigestive practice and was a key contributor to the multidisciplinary aerodigestive, vascular anomalies, and velopharyngeal insufficiency programs. At the Mayo Clinic Children’s Center, Dr. Balakrishnan also served as a surgical quality leader and championed the development of a comprehensive pediatric surgical quality program. Dr. Balakrishnan joined the Stanford Department of Otolaryngology – Head & Neck Surgery and Lucile Packard Children’s Hospital faculty as associate professor in early 2020. With this appointment, he also took on the role of medical director for surgical performance improvement at Stanford Lucile Packard Children’s Hospital. He also serves in several other leadership roles in Stanford Medicine, including co-chair of the Teamwork Advisory Council, co-lead for the Otolaryngology department's diversity/equity/inclusion program, and NSQIP-Pediatric Surgeon Champion. In 2022, he was appointed the Susan B. Ford Surgeon-in-Chief of Stanford Medicine Children's Health and Lucile Packard Children's Hospital.
Dr. Balakrishnan studies ways to improve outcomes of pediatric airway reconstruction for diseases such as laryngotracheal, subglottic and tracheal stenosis, congenital tracheal stenosis and complete tracheal rings, laryngeal clefts, and vocal fold immobility and paralysis. He also examines the same questions for vascular malformations such as lymphatic malformations, venous malformations and hemangiomas.Dr. Balakrishnan's research focuses on ways to standardize treatments and measure outcomes in these complex diseases, as well as ways to reduce treatment costs and medical errors, particularly those related to cognitive bias. By improving outcomes and reducing costs, he aims to improve the value of care, while also optimizing patient and caregiver experience during the care process. Focus areas1. Standardizing outcomes and processes in pediatric airway reconstruction. Dr. Balakrishnan co-leads unique international and national multidisciplinary collaborative groups to develop standard processes and outcome measures for airway surgery and aerodigestive (breathing/voice/swallowing) care in children. His previous work has led to the development of similar standards for lymphatic malformations in the head and neck and for reconstructive surgery of the larynx (voice box) and trachea (windpipe) in children. He has internationally recognized expertise in developing consensus statements for these complex questions.2. Costs of otolaryngology care. Dr. Balakrishnan has studied thousands of patients and otolaryngology operations to identify factors that may predict more costly medical care. This will lead to process improvements that will allow Stanford and other institutions to reduce the cost burden that patients and the U.S. health care system face while maintaining quality and access to care. Dr. Balakrishnan's current work connects these costs to the outcomes and value of care provided.3. Cognitive bias and implicit bias and medical error. Dr. Balakrishnan is working to improve otolaryngology resident and provider education related to the effects of cognitive and implicit bias on medical decision-making, and ways to reduce medical errors related to those biases.4. Evidence-based care of vascular anomalies. Dr. Balakrishnan leads a task force of colleagues around the country to develop better scientific evidence to guide the care of challenging vascular anomalies such as lymphatic malformations.5. Innovative approaches to pediatric airway reconstruction. Dr. Balakrishnan has studied several minimally invasive endoscopic approaches to airway surgery and is currently developing new robotic techniques to reconstruct the airway.Significance to patient careComplex and rare conditions such as airway stenosis and vascular malformations greatly impact children's survival and quality of life, but treatment pathways and standardization of care are still lacking. Dr. Balakrishnan hopes that increasing standardization of care and outcome reporting for these conditions will help doctors provide better care for these patients, with reduced costs and a better experience for children and their families and caregivers. Meanwhile, by developing and studying new and potentially better ways to do airway surgery, Dr. Balakrishnan hopes to provide families with innovative options that may better suit their children's needs.