Center for Airway, Voice & Swallowing

The Center for Airway, Voice and Swallowing, also known as the Aerodigestive Center, provides state-of-the-art care for children with complex disorders affecting airway, breathing, feeding, swallowing, and growth.

Our multidisciplinary Aerodigestive Center consists of pediatric specialists from Otolaryngology, Pulmonology, Gastroenterology, Speech and Language (Swallow) Pathology, and Pediatric Surgery. Appointments with our team include a coordinated visit with pertinent specialists and concurrent diagnostic tests or interventions. For many patients, coordinated surgical endoscopy (also called a “triple scope”) is the next step in evaluation and treatment.

Our synchronized approach offers many advantages for patients and families, including fewer doctor visits and missed days of school/work; fewer exposures to anesthesia; less time to effective treatment; and, by combining surgical procedures and minimizing off-target testing, families generally see fewer out-of-pocket medical costs. Ultimately, our collaboration yields more comprehensive, sophisticated, and effective treatment for this vulnerable population.

We offer specialty care centers in Farmington, Glastonbury, and Hartford. Full aerodigestive team clinics are held three times monthly (Hartford, Farmington). Focused specialty clinics are also offered: Airway clinics are held twice weekly (Hartford), voice clinics are held twice monthly (Glastonbury, Farmington), and swallow clinics are held twice monthly (Hartford, Farmington). We now offer telemedicine for these visit types as well.

The year 2020 was challenging for us all as we faced the biggest health care crisis of our lifetimes. Our team is dedicated to caring for children with airway problems, and SARS-CoV-2 is an airway virus. While many specialties had to initially slow down and handle emergencies only, our specialists had to soldier on. This meant we had to balance our mission for unwavering delivery of care with our commitment to keeping our team members safe. This was no easy task given early lack of testing and lack of personal protective equipment (PPE). Our center director, Dr. Nicole Murray, is co-chair of Connecticut Children’s PPE Task Force and helped ensure Connecticut Children’s front line health-care workers were safe by developing protocols for the use and reprocessing of N95’s and other PPE. She made appearances on local news outlets and filmed educational videos for families as they considered how to keep their children safe as schools and society reopened.

Our team continued our focus on safety this year by launching two initiatives for our patients with tracheostomies: We developed pathways for in-home Covid testing and also for provision of tracheostomy “Go-Bags,” so that our tracheostomy population can shelter at home and not leave for testing, and that when they do need to leave, they are even better prepared with their critical supplies for the road.

Our team also harnessed 2020 technology to continue to provide care. We were very early adapters of telemedicine, and launched comprehensive multidisciplinary aerodigestive team telehealth clinics even before some insurance carriers were reimbursing us for them.

Despite the pandemic, our team also proceeded this year with a record number of complex open airway reconstructions and tracheostomy decannulations, which are always wonderful milestones towards “normalcy” for our families and children.

PUBLICATIONS

Munjal T, Kavanagh KR, Ezzibdeh RM, Valdez TA. The impact of Covid-19 on global disparities in surgical training in pediatric otolaryngology. Int J Pediatr Otolaryngol. 2020 Nov; 138:110267.

Kashat L, Carter B, Mosha M, Kavanagh KR. Mindfulness education for otolaryngology residents: a pilot study. OTO Open. 2020 Jul-Sep; 4(3): 2473974X20945277. Epub ahead of print.

Kashat L, Carter B, Archambault M, Wang Z, Kavanagh KR. A multidisciplinary basic airway skills boot camp for novice trainees. Cureus. 2020 Jun 22; 12(6): e8766. doi: 10.7759/cureus.8766.

Mehta K, Mosha MM, Kavanagh KR. A targeted tracheostomy care educational initiative to augment resuscitation training in the pediatric setting. Int J Pediatr Otolaryngol. 2020 Jun; 133:109944. doi: 10.1016/j.ijporl.2020.109944. Epub ahead of print.

Kashat L, Carter B, Falcone T, Parham K, Kavanagh KR. Taking a systematic approach to resident wellness: a pilot study. Otolaryngol Head Neck Surg. 2020 Apr; 162(4):489-491. doi: 10.1177/0194599820907589. Epub ahead of print.

Grover N, Zeisler B, Wilson JD. Hemorrhagic tonsillitis in an infant: a case report. Int J Pediatr Otorhinolaryngol. 2020 Sep; 136;110190. https://doi.org/10.1016/j.ijporl.2020.110190.

BOOK CHAPTERS

Murray N. Pediatric tracheostomy. In: Pediatric otolaryngology for primary care. 2nd ed. Itacsa, IL: American Academy of Pediatrics; 2020. p. 449-470.

Lee S, Murray N. Sinonasal manifestations of cystic fibrosis. [updated] In: Otolaryngology and facial plastic surgery. Medscape (formerly eMedicine World Medical Library); 2020. https://emedicine.medscape.com/ article/862538-overview.

STAFF

Nicole Murray, MD, Director, Center for Airway, Voice, and Swallowing Pediatric Otolaryngology

Rebecca Strong, CPNP, APRN Clinical Coordinator

Barbara Mulholland, RN, BSN, CPN, CNRN Nursing Coordinator

Claribel Vega, MA Administrative Coordinator

Renee Grenier, MA Special Scheduler

Katherine Kavanagh, MD Pediatric Otolaryngology

Craig Lapin, MD Pediatric Pulmonology

Anne McLaughlin, MD Pediatric Pulmonology

Christine Rader, MD Pediatric Surgery

Victoria Grossi, DO Pediatric Gastroenterology Corey Baker, MD Pediatric Gastroenterology

Peter Townsend, MD Pediatric Gastroenterology

Bella Zeisler, MD Pediatric Gastroenterology

Sara Burnham, MA, CCC-SLP Speech-Language Pathology

Kamie Chapman, MS, CCC-SLP Speech-Language Pathology

Kathryn Fields, MS, CCC-SLP Speech-Language Pathology

Kerri Byron MS, CCC-SLP Speech-Language Pathology

Katie McLoughlin, MS, CCC-SLP Speech-Language Pathology

Virginia M. Van Epps, MEd, CCC-SLP, CLC Clinical Manager, Speech-Language Pathology

Anna Maria Mennella, LMSW Family Support Clinician

Debbie Verkin-Siebert, RD, CSP, CD-N Registered Pediatric Dietitian