Cleveland Clinic Children's Pediatric Center for Airway, Voice and Swallowing Disorders (PCAVS) is an aerodigestive program offering integrated team assessment and care from multiple medical and surgical specialists for infants, children, and adolescents.
Patients with complex medical conditions of the upper and lower airway and respiratory system, esophageal disorders, and swallowing and digestive issues are the focus of this team approach. We see patients with complex congenital or acquired aerodigestive disorders, including but not limited to those with tracheostomies.
Patients can often be seen at a single location during one half-day visit and we are a state of the art facility equipped to treat a wide range of conditions both medically and surgically.
A sequence of visits is tailored for each child, who typically spends 30 minutes with each specialist. The team later holds a debriefing to discuss findings, progress and the treatment plan.
During the clinic, in-office diagnostic procedures and periodic endoscopic airway assessments can be performed. If additional problems are discovered, they can be addressed at the same visit. Should surgical intervention be required, we often combine a multi-team approach to perform several procedures simultaneously thus limiting exposure to anesthesia.
What We Treat
Aerodigestive conditions — from neurologic and sleep disorders to feeding problems and complications from tracheotomy — our experts provide comprehensive care that addresses your child’s unique needs.
Learn more about some of the complex aerodigestive disorders we treat, including:
- Airway obstruction.
- Apnea (central and obstructive).
- Bronchogenic cysts.
- Bronchopulmonary dysplasia.
- Chronic aspiration (tracheotomy dependent).
- Craniofacial syndromes that cause airway obstruction and associated feeding problems.
- Dysphagia (feeding and swallowing problems).
- Enlarged adenoids.
- Eosinophilic Esophagitis.
- Esophageal atresia.
- Esophageal duplications.
- Esophageal web or stricture.
- Gastroesophageal reflux (GER) in infants, children and adolescents.
- Glottic stenosis.
- Hypoplastic lung.
- Interstitial lung disease.
- Laryngeal atresia.
- Laryngeal cleft.
- Laryngeal web.
- Laryngeal / tracheal / bronchial papillomatosis (sexually transmitted diseases).
- Laryngomalacia (usually severe cases).
- Sleep disorders.
- Subglottic stenosis.
- Tracheal stenosis.
- Tracheoesophageal fistula (TEF).
- Vocal cord paralysis.
- Voice disorders.
The pediatric otolaryngology providers on the PCAVS team are responsible for:
- Evaluating the upper airway and trachea to see what medical or surgical interventions can best improve upper airway obstruction.
- Addressing conditions such as drooling.
- Working towards tracheostomy decannulation, if possible.
In addition, they strongly encouraged that all children — especially those with special needs —have their hearing evaluated and optimized.
Physicians and nurse practitioners from the Center for Pediatric Pulmonary Medicine specialize in the evaluation, management, and coordination of care for respiratory issues. This may include:
- Ventilatory support and supplemental oxygen.
- Airway clearance therapies.
- Sleep-related breathing disorders care.
- Diagnostic procedures — including imaging studies, blood work, allergy skin testing/screening, spirometry (pulmonary function tests), and exercise testing.
- Diagnostic flexible bronchoscopy to evaluate airways and to obtain respiratory secretions samples (bronchoalveolar lavage) under sedation.
Pediatric Gastroenterology (GI) providers work closely with the dietician to follow your child's growth and feeding. They will address issues with swallowing, reflux, abdominal pain, constipation, and other GI concerns. In addition, they participate in joint operative evaluations when GI endoscopy is needed.
Physical Medicine and Rehabilitation (PM&R)
The role of our pediatric physiatrists is to ensure that:
- Development and physical functioning are progressing optimally.
- Neuromuscular complications, such as spasticity, scoliosis and joint contractures, are monitored and treated appropriately.
The pediatric registered dietitian on the PCAVS team focuses on the nutritional needs of the patient. This includes:
- Assessing the nutritional needs of the patient.
- Creating specialized, nutrition care plans to support growth and development throughout childhood.
- Ensuring adequate nutrition as the child ages through collaboration with the multi-disciplinary team on feeding options and transition.
Diana Schnee, MS, RD, CSP
Our Speech-Language Pathologist on the PCAVS team assesses the patient and makes recommendations for feeding, swallowing voice (including the use of a Passy Muir Speaking Valve), and speech and language development.
Clinical Speech-Language Pathologist
Pediatric Palliative Care
The Pediatric Palliative Care team assesses the “big picture” — looking at your child’s needs, caregivers’ recommendations, and resources available at home. The team made up of nurse practitioners, a nurse coordinator, and a physician, collaborates with all PCAVS providers and parents to ensure that the patient’s best interests and the parents’ goals are addressed.
Case Management/Social Work
The pediatric social worker on the PCAVS team is there to support the patient’s entire family. Support is offered for the family using a holistic approach to care. Ways that the social worker can provide assistance include:
- Clinical and emotional support.
- Referrals for community resources.
- Help with an application for financial assistance.
- Support with navigating the school system.
Case Management Social Worker
The PCAVS administrator helps coordinate appointments and triages phone calls to meet the appropriate clinical needs of our patients.
Coordinators and Clinical Support
These team members facilitate communication between the multidisciplinary teams to simplify access to information and to avoid duplication of services and unnecessary costs. They also work to improve the quality of life for our pediatric patients and their family members by providing the education and resources necessary for optimizing physical and emotional health.
- Diane Cowles, RN
- Anne Banas, CNP
Pediatric Center for Airway, Voice and Swallowing Disorders (PCAVS)
After you call to arrange an initial appointment with our PCAVS team, one of our providers will reach out to you to perform a pre-visit intake. Please make arrangements to have copies of prior imaging, imaging reports, operative notes, laboratory studies, pathology reports, audiograms, and consult notes available that you would like us to review prior to your appointment.
- Health Library – Index of ENT-related topics
- Children with Medical Handicaps Program (BCMH) – Pediatric ENT contact Number for BCMH: 216-445-0075; option 4
- Cleveland Clinic Children's Child Life Services – Child Life Services offers surgery tours and a variety of programs to help your child prepare for surgery and during their inpatient stay.
- Fresh Air Camp
- Head and Neck Innovations Podcast: Driving Patient Care and Research to Treat Pediatric Aerodigestive Disorders
Your generous support for Pediatric Otolaryngology will help fund the future care of children via:
- Pediatric Otolaryngology Specialty Program Support
- Research Projects
- Resident Education and Educational Travel Grants for Trainees
Thank you for your support!