Pediatric airway team with patient 

Medical and Surgical Treatments

There are several interventions and procedures, which may be medical or surgical, available in the Pediatric Airway, Voice, and Swallowing Center. Determining which are most appropriate for your child is a decision to be made after your child has been evaluated by one of our physicians. If you would like to schedule an appointment, you may request one online or call us at 617-573-3190. 


Learn more about the treatment interventions and procedures we offer:

Adenoidectomy

The adenoid is a mass of lymphatic tissue that exists in the nasopharyx (the back of the nose). It can obstruct breathing, block drainage from the ears to the throat, and be a source of chronic and recurrent infection to the ears and sinuses. 

The adenoid is typically removed to relieve airway obstruction and/or to help with infections. 

Most of the time, it is performed as an outpatient procedure (go home say day). It may be performed in conjunction with a tonsillectomy. An adenoidectomy with or without a tonsillectomy takes approximately 30 minutes to perform.

Pediatric Tracheostomy and Airway Reconstruction Surgery

A tracheostomy is a surgically created opening through the neck and into the windpipe that provides a passage for air when the typical route is blocked. It may be used temporarily or for long-term management of airway obstruction. Tracheostomy is used to treat airway obstruction that can be caused by a variety of conditions, including:
  • Tumors (abnormal growths) in the larynx or trachea
  • Subglottic stenosis (narrowing of airway below the vocal folds and above the trachea)
  • Tracheomalacia (softening of tissue of the trachea)
  • Laryngomalacia (softening of tissue of the larynx)
  • Vocal cord paralysis (inability of vocal fold movement)
  • Hemangioma (a vascular malformation in the larynx or trachea)
  • Choanal atresia (narrowing or blockage of nasal passage)
  • Complete tracheal ring (a defect in the cartilage rings that causes narrowing of tracheal passage)

Related Articles

The impact of pediatric tracheotomy on parental caregiver burden and health status
Drilling speaking valves: A modification to improve vocalization in tracheostomy dependent children
Interdisciplinary development and implementation of communication checklist for postoperative management of pediatric airway patients
Clinical consensus statement: Tracheostomy care
Final validation of the Pediatric Tracheotomy Health Status Instrument (PTHSI)
Case 7-2009: A pregnant woman with a large mass in the fetal oral cavity


Surgical Videos

The following video depicts a graphic surgical procedure and is intended for professional use only.

Pediatric Tracheostomy

Pediatric Airway Reconstruction

Airway reconstruction is a surgical procedure designed to reconstruct the trachea and larynx of children who have narrowing of the airway. The narrowing occurs for a variety of reasons, such as prolonged intubation or trauma. Reconstruction of the airway often results in being able to remove the tracheostomy tube and being able to breathe without it.

Pediatric airway reconstruction may also be useful for children born with narrow airways that don’t have a tracheostomy but suffer from recurrent croup episodes or exercise intolerance.

When the narrowing is just below the vocal cords, we call this narrowing subglottic stenosis. When the airway narrowing is lower down in the trachea (airpipe), we call this tracheal stenosis

There are two different surgical approaches that may be used to treat subglottic stenosis:

  • Laryngotracheal reconstruction: Aims to make the airway bigger.
  • Cricotracheal resection: Designed to remove the scarred airway and bring the sections just above and below the scarred area together.

Surgery for tracheal stenosis is divided into primary resection and reanastomosis (tracheal resection and re-anastomosis) or a procedure for longer sections of narrowing called a slide tracheoplasty.


Surgical Videos

The following videos depict graphic surgical procedures and are intended for professional use only.

Double-staged LTR
Rib Graft Harvest
Cricotracheal Resection
Tracheal Resection and Reanatomosis
Slide Tracheoplasty
Suprastomal Granuloma Excision
Choanal Atresia Repair

Synagis Vaccine

Synagis is a vaccination to help prevent respiratory syncytial virus (RSV) in children with tracheostomies. RSV is a viral infection that is common among children who were born prematurely during the winter season (when children get sick most often). This vaccine is offered through your pediatrician’s office. Please contact them for details. 

Tonsillectomy

Tonsillectomy is the surgical removal of the tonsils, frequently performed with an adenoidectomy. This procedure usually takes place due to recurrent tonsil infections or strep throat (despite antibiotic therapy) or from upper airway obstruction and/or obstructive sleep apnea (enlarged tonsils can often the airway and cause difficulty breathing).

The surgery takes approximately 45 minutes. Please plan for your child to remain in the hospital for several hours after the outpatient surgery or overnight if admitted. Recovery time is around 10 to 14 days, and children will have to be on a soft diet after surgery.