First-of-Its-Kind Program in Florida Provides Comprehensive Care for Children with Complex Airway and Swallowing Disorders

As the founder of Tampa Children’s ENT and the Medical Director of Pediatric Otolaryngology at St. Joseph’s Children’s Hospital, Dr. Karin Hotchkiss specializes in all things ears, nose, and throat for children – treating everything from nose sniffles to conditions requiring life-changing surgeries to clear airways and improve swallowing capabilities. As the mom of three daughters, she also knows what it’s like to worry about the health of her children.

She is especially proud to lead one of the premier aerodigestive programs in the country, located right here at St. Joseph’s Children’s Hospital, sharing, “It’s a top tier program and patients come from not only the state of Florida but also all over the southeast to be a part of it. We’ve helped over 350 children and their families and as more people learn about the program those numbers continue to grow.”

Many of her young patients come to Dr. Hotchkiss with complex airway and swallowing disorders and are being treated by multiple specialists and therapists – When you consider 15% of pediatric patients are considered medically fragile, this program helps provide another medical home for this group of patients. 

“Navigating complex medical issues can be especially challenging for both the child and their family,” she explains. “Quite often they require several procedures or surgeries involving ENT, pulmonology, and gastroenterology.”

A little over six years ago Dr. Hotchkiss was starting to see a national trend toward providing “one stop” multidisciplinary clinics for children with aerodigestive disorders and realized there was nowhere in Florida where patients like hers could find that type of comprehensive treatment. She decided to change that, approaching two of her colleagues – Dr. John Prpich in pulmonology and Dr. Shivinder Narwal in gastroenterology – with the idea of creating an aerodigestive clinic at St. Joe’s. They were enthusiastically on board.

“One area we know causes a lot of stress is the various procedures and surgeries these kids have to go through. If they could have multiple procedures or surgeries done in the same day it decreases the risk for the patient, fosters collaboration and real-time sharing of care plans among the clinicians, and provides an overall better experience for both the patient and their families.”

To make it happen, she needed a specially equipped surgical suite to be available so each of the specialty areas involved could do their specific task. For example, a child might need both an endoscopy (GI) and adenoid removal (ENT), which in the past would happen over two separate days and two separate procedures.

“One of the wonderful things about being a part of St. Joe’s is their openness to consider new ideas. When we explained the need for a surgical suite as part of a more formal aerodigestive program, St. Joe’s was more than happy to find a way to make it happen.”

Now a team of doctors, nurses, and physical, occupational, speech and auditory therapists all work closely together to provide comprehensive evaluations, assessments and care plans for patients suffering from often debilitating airway and swallowing conditions.

The results have been life-changing.

One of Dr. Hotchkiss’ two-year-old patients had been suffering from a chronic cough, sleep issues, and poor feeding. Prior to joining the program at St. Joe’s, she had endured multiple surgeries, feeding issues meant she needed a g- tube for failure to thrive, and sleep apnea threated her overall general health.   In a single surgery the aerodigestive team was able to address the sources of her sleep issues, cough, and reflux.   After team intervention, her sleep improved.  She was able to feed by mouth and get rid of her g tube.  And as of her last visit she is growing and gaining weight.

Another young patient was experiencing chronic mouth breathing, repeated sniffing, and constant throat clearing with a cough.  When he was referred to the program the six-year-old boy’s symptoms were so prominent they led to issues in school as his teacher noted they were causing a disturbance to the classroom.  Team intervention with triple endoscopy addressed reflux issues, breathing issues, and identified underlying allergies. Since then, his cough has resolved, and he is sleeping well.  He’s back in school and the classroom setting is markedly improved.

“When the pieces are seamlessly working together through a program like this, outcomes like these aren’t an anomaly. When I tell parents I have a way to help, I can see their immediate relief.”

The success of the program means more resources are needed to continue to ensure St. Joe’s Kids can provide the best available aerodigestive pediatric care, including being able to offer innovative equipment and procedures like Fiberoptic Endoscopic Evaluation of Swallowing (FEES). FEES is an instrumental examination of swallowing performed by a Speech Language Pathologist (SLP) used to assess swallowing safety and function, secretion management and to diagnose dysphagia without the use of radiation and its availability will give St. Joe’s Kids an important tool to provide pediatric patients with the highest level of care.

Dr. Hotckiss is confident about the future.

“St. Joe’s always finds a way to come through – and I know that’s due in large part because we have such wonderful support from our community of donors. And I know with their help, St. Joe’s will continue to lead the way to providing the best available care for the children of our community.”

Your support of programs like these makes a difference. Donations can be made here.