Operation airway: the first sustainable, multidisciplinary, pediatric airway surgical mission

Ann Otol Rhinol Laryngol. 2014 Oct;123(10):726-33. doi: 10.1177/0003489414534012. Epub 2014 May 16.

Abstract

Objective: This study aimed to describe the development and implementation of the first sustainable, multidisciplinary, pediatric airway surgical mission in an underserved country.

Methods: This prospective, qualitative study was conducted for the first 4 Operation Airway missions in Quito, Ecuador. The major goals of the missions were to assist children with aerodigestive abnormalities, create a sustainable program where the local team could independently provide for their own patient population, develop an educational curriculum and training program for the local team, and cultivate a collaborative approach to provide successful multidisciplinary care.

Results: Twenty patients ages 4 months to 21 years were included. Twenty-three bronchoscopies, 5 salivary procedures, 2 tracheostomies, 1 T-tube placement, 1 tracheocutaneous fistula closure, 2 open granuloma excisions, and 6 laryngotracheal reconstructions (LTRs) were performed. All LTR patients were decannulated. A new type of LTR (1.5 stage) was developed to meet special mission circumstances. Two videofluoroscopic swallow studies and 40 bedside swallow evaluations were performed. One local pediatric otolaryngologist, 1 pediatric surgeon, 3 anesthesiologists, 7 intensivists, 16 nurses, and 2 speech-language pathologists have received training. More than 25 hours of lectures were given, and a website was created collaboratively for educational and informational dissemination (http://www.masseyeandear.org/specialties/pediatrics/pediatric-ent/airway/OperationAirway/).

Conclusion: We demonstrated the successful creation of the first mission stemming from a teaching institution with the goal of developing a sustainable, autonomous surgical airway program.

Keywords: Operation Airway; mission; pediatric; surgical.

MeSH terms

  • Adolescent
  • Airway Management*
  • Child
  • Child, Preschool
  • Developing Countries*
  • Ecuador
  • Humans
  • Infant
  • Medical Missions / organization & administration*
  • Otolaryngology*
  • Patient Care Team / organization & administration*
  • Pediatrics*
  • Program Evaluation
  • Prospective Studies
  • Young Adult