Pediatric Otolaryngology

The Mayo Clinic Department of Otolaryngology — Head and Neck Surgery's Division of Pediatric Otolaryngology works to provide cutting-edge care for pediatric patients, with multidisciplinary team members including:

• Gastroenterologists.
• Geneticists.
• Maternal-fetal medicine specialists.
• Neonatologists.
• Pediatric anesthesiologists.
• Pediatric pulmonologists.

Researchers in the division are establishing best-practice guidelines for children with complex aerodigestive and congenital hearing problems. They also are finding novel solutions for complex and rare problems in utero and participating in fetal surgery and ex utero intrapartum treatment (EXIT) procedures.

The division has several active pediatric clinics, including:

• A craniofacial clinic.
• A multidisciplinary velopharyngeal insufficiency clinic.
• A vascular malformation clinic.
• An aerodigestive clinic.

All offer unique opportunities to study rare diseases, develop innovative team-based treatments and work toward excellent clinical outcomes for Mayo Clinic's complex pediatric patient population.

Global medicine

Mayo Clinic strives to provide care to everyone in need, especially those who lack access to safe and affordable surgery. The Division of Pediatric Otolaryngology has developed global partnerships to help deliver care through clinical practice and education. These bidirectional partnerships help find and address gaps in surgical capacity, knowledge and surgical skill. Through both on-site and tele-education, the division develops and delivers interventions to improve education, patient care and sustainable surgery in areas with limited resources.

These partnerships also have uncovered rare disease processes not commonly seen in the United States. By studying these rare diseases, along with gaps in access and clinical capabilities, Mayo Clinic otolaryngology researchers aim to help shape medical education and elevate the level of care that can be provided worldwide.

The Department of Otolaryngology — Head and Neck Surgery aims to expand access and quality of care by using established international communities and resources. Clinicians and investigators participate in bidirectional education with the goal of sharing the expertise learned in international settings and creating the best treatment protocols.

Rare infectious diseases

The Division of Pediatric Otolaryngology leads international, multi-institutional collaborations to help find novel solutions and guide evidence-based management of rare infectious diseases. Such diseases and conditions include intracranial complications of sinusitis as well as atypical mycobacterial infections.

Velopharyngeal insufficiency and cleft lip and palate

The inadequate closing of the velopharyngeal sphincter — also called velopharyngeal insufficiency — is often due to a congenital abnormality. It results in problems such as hypernasal speech or regurgitation of fluids through the nose when swallowing. Treatment options for velopharyngeal insufficiency include various surgical techniques or the use of injectable filler.

The Division of Pediatric Otolaryngology's database of patients seen in Mayo's velopharyngeal insufficiency clinic allows investigators to compare outcomes, such as voice and perceptual analysis, between children who have undergone surgery and those receiving injectable filler. Other projects on velopharyngeal insufficiency include investigation of the use of intranasal flaps to augment surgical repair of oronasal fistulas, research into the impact of hyperbaric oxygen therapy on wound healing in the palate and cutting-edge studies of the repair of fetal cleft lip.

Aerodigestive tract disorders

Proper neurological and anatomical development of the upper aerodigestive tract is essential for healthy feeding and breathing. The Division of Pediatric Otolaryngology's research into diseases and conditions of the upper aerodigestive tract includes collaboration among aerodigestive team members to evaluate this patient population by establishing a national registry, best-practice guidelines and outcomes reporting.

The division also conducts studies to better understand the health needs and challenges of children with pediatric feeding concerns who also have aerodigestive diagnoses. The goal of this research is to provide patients with better outcomes, such as improved growth and feeding and decreased aspiration.

Otitis media and adenotonsillar disease

The division's research into middle ear infections — also called otitis media — and adenotonsillar disease include:

• A device trial using a single-pass tool to place tympanostomy tubes with moderate sedation.
• A device trial using a single-pass tool to place tympanostomy tubes with topical anesthesia in awake children in the clinic setting.
• Evaluation of postoperative care of children under age 5 undergoing tonsillectomy and use of rectally administrated pain medication to reduce emergency room visits and admissions for dehydration.
• Evaluation of surgical treatment of obstructive sleep apnea in children with trisomy 21, commonly known as Down syndrome.