“The Surgical Management of Esophageal Disease – the Role of the Otolaryngologist”

PROGRAM DESCRIPTION: Aerodigestive medicine with its emphasis on interdisciplinary care is rapidly evolving and expanding, both nationally and internationally. Children with esophageal diseases are increasingly recognized as beneficiaries of interdisciplinary care, and the role of the otolaryngologist in that care has also expanded.
While this course will have an emphasis on the surgical management of esophageal disease, it will also discuss the complimentary and interdisciplinary nature of diagnosis and management of these complex children. The disorders to be discussed will include severe (type 3 and 4) laryngotracheoesophageal clefts, tracheoesophageal fistulae, esophageal atresia, button battery injuries, caustic ingestion, esophageal strictures and esophageal replacement. Nuances of endoscopic and open repair of clefts and TEFs will be discussed, including the tracheal transection technique for type 4 clefts, and slide tracheoplasty for complex TEF management, techniques both developed in Cincinnati. We will also discuss the role of otolaryngology in working with pediatric surgery to provide esophageal exposure and mobilization.
While the discussion will be mainly case based, we will also discuss health inequities, including of both risk (caustic ingestion and button battery exposure), and longer-term follow-up, especially of children with esophageal atresia, which is increasingly recognized as a lifelong disease.
I would also note that over the last century ENT has steadily expanded its “footprint” (we are now head and neck surgeons, thyroid surgeons, skull base surgeons etc), and esophageal surgery is a logical area where we can have a very positive impact on patient care.

OUTCOME OBJECTIVE 1: To familiarize attendees with the interdisciplinary and complimentary methods of evaluating children with esophageal atresia, tracheoesophageal fistulae, and severe (type 3 and 4) laryngotracheoesophageal clefts.

OUTCOME OBJECTIVE 2: To discuss both the endoscopic and open approaches to repairing severe laryngeal clefts and tracheoesophageal fistulae. This will include gaining familiarity with specific techniques for repair, including endoscopic type 3 cleft repair, and slide tracheoplasty for challenging TEFs.

OUTCOME OBJECTIVE 3: To appreciate the role of otolaryngology in the interdisciplinary care of children with esophageal disease, and their ongoing care needs, especially those with esophageal atresia.

BACKGROUND STATEMENT: Aerodigestive care is rapidly expanding, and children with esophageal diseases are ideal candidates for such care. The role of otolaryngology in the care of these children is also evolving and expanding. Our Aerodigestive team has developed many of the surgical techniques now used in their care

Comprehensive Otolaryngology Track Statement :