Clinical/Medical Services
Complex Airway Evaluation & Reconstruction Laryngology & Voice Clinic
Otology & Otitis Media Tracheostomy/Home Ventilation (Trach/Vent) Clinic
Universal Newborn Hearing Screening Obstructive Sleep Disorders Program
Dysphagia (Swallowing Disorders) Clinic Cleft Palate Clinic
Cochlear Implant Program Drooling Management Clinic
Vascular Malformations Clinic Maxillofacial Trauma Clinic
Complex Airway Evaluation & Reconstruction
A major facet of Pediatric Otolaryngology is the evaluation and surgical management of patients with complex airway difficulties.
Over 100 procedures to evaluate, treat and reconstruct the airway in these often critically ill patients were performed by the Division of Pediatric Otolaryngology at Children's Hospital of Wisconsin in 2002.
In addition, Dr. Kerschner developed a new procedure for closure of tracheo-esophageal fistulas using a KTP laser. The first-ever KTP-laser assisted endoscopic closure of a tracheo-esophageal fistula was performed at Children's Hospital of Wisconsin and the Medical College of Wisconsin in October.
Otology & Otitis Media
For children who are born with or develop ear problems that require a specialized expertise, the Division of Pediatric Otolaryngology has experts to perform complex ear procedures for cholesteatoma, hearing restoration and congenital malformations of the ear, including microtia and atresia. The number and variety of procedures performed has made this the preeminent Pediatric Otology program in Wisconsin.
The Division of Pediatric Otolaryngology also provides a comprehensive program for the assessment of hearing loss. For children with profound hearing loss, cochlear implantation is available. In addition, the Division has great expertise in caring for children with difficulties related to otitis media and is a leading center in the U.S. in otitis media research with funding through the National Institutes of Health.
Universal Newborn Hearing Screening
Dr. Kerschner played a pivotal role in bringing Universal Newborn Hearing Screening to Wisconsin. His efforts have helped to implement legislation mandating hearing screening for infants of Wisconsin. Dr. Kerschner is the only otolaryngologist in Wisconsin named to the Universal Newborn Hearing Screening Implementation Working Group for Wisconsin.
His work continues to bring improvements in programs designed to identify children with hearing loss early in life and to provide them with early intervention. In 2002, Dr. Kerschner received a gubernatorial citation from Governor Scott McCallum recognizing his efforts in this area.
Dysphagia (Swallowing Disorders) Clinic
The Division of Pediatric Otolaryngology has quickly become a national leader in the area of pediatric dysphagia. The Fiberoptic Endoscopic Evaluation of Swallowing and Sensory Testing (FEEST) Clinic at Children's Hospital that was established by Dr. Kerschner to provide state-of-the-art swallowing evaluation to children with complex swallowing disorders.
This technology continues to be available at only a few pediatric institutions in this country. Dr. Kerschner performed approximately 30 of these procedures at Children's Hospital during the past year, attracting patients from many parts of the country and abroad These patients with complex swallowing difficulties are managed in a multidisciplinary fashion with Departments of Gastroenterology and Speech Pathology.
Cochlear Implant Program
Dr. Wackym directs the Pediatric Cochlear implantation Program at Children's Hospital of Wisconsin and the Medical College of Wisconsin.
This program has developed national prominence and is one of the largest in the Midwest. Dr. Wackym and the cochlear implant team have made a number of important contributions toward improvement of hearing in children and infants through their research efforts.
There are several areas of on-going research including: cochlea implant performance to identify possible predictors of post-implant performance and/or rehabilitation factors that can improve post implant performance, and evaluation of speech understanding at soft and normal loudness levels to identify how cochlear implant users perform at levels that mimic real life listening situations.
Vascular Malformations Clinic
Dr. Kerschner has been recognized as a regional expert in the management of complex vascular malformations of the head and neck region. His particular area of interest is lymphangiomas and he is the principal investigator for a Phase III FDA trial examining the efficacy of using Picibanil as a sclerosing agent for these lesions.
Dr. Kerschner's efforts allows Children's Hospital of Wisconsin and the Medical College of Wisconsin to be the only institution in southeastern Wisconsin to be able to provide this new treatment option, which has shown significant promise to date.
Dr Kerschner's interests in vascular malformations has also lead to collaboration with dermatology, radiology, plastic surgery, and oncology to produce the only multidisciplinary pediatric vascular malformations clinic in Wisconsin. The Children's Hospital Vascular Malformations Clinic provides multidisciplinary care to the most complex patients on a monthly basis.
Laryngology & Voice Clinic
The Division of Pediatric Otolaryngology has developed one of the nation's first clinics specifically designed to diagnose and treat voice disorders in pediatric patients. These include patients that have had surgery in or around the area of their voice box, professional singers, patients who have functional disorders and patients who have neurologic conditions.
Tracheostomy/Home Ventilation (Trach/Vent) Clinic
Children with airway problems that require tracheostomy tube placement have the potential for significant morbidity and mortality. They also often require long-term specialized care for their tracheotomy site, underlying airway problem, and other associated medical problems.
Specialized centers to assist with the unique problems of these children have contributed to a significant decrease in morbidity associated with pediatric tracheostomy. The Trach/Vent Clinic at Children's Hospital of Wisconsin is a multi-disciplinary clinic meeting twice monthly that allows patients to be seen by all of the various specialists providing care for their problems in a single visit.
As the clinic's pediatric otolaryngologists Dr. Kerschner and Dr. Conley examine the tracheostomy site and assesses progress regarding the underlying causes necessitating the tracheostomy, and any other ongoing ear, nose, or throat problems. Pulmonologists, respiratory therapists, nurses, and dieticians also work in a coordinated approach to simplify medical care for these patients and their families.
Obstructive Sleep Disorders Program
Obstructive sleep disorders have been recognized in recent years as a significant cause of morbidity in children, associated with developmental delays, behavior problems, and learning difficulties.
Children with signs of upper airway obstruction such as loud snoring or apnea should be evaluated for causes of their airway obstruction, which are most frequently related to enlarged tonsils and adenoids.
The Division of Pediatric Otolaryngology works closely with pediatric pulmonology in evaluating these children. In addition, a number of research efforts being led by Dr. Valerie Flanary are being conducted by the Division at Children's Hospital to further our understanding of how obstructive sleep disorders affect children.
Cleft Palate Clinic
The Cleft Palate Clinic at Children's Hospital of Wisconsin, which meets twice-a-month, is a multi-disciplinary clinic that allows patients to be seen by all of the various specialists caring for the problems associated with their cleft palate in a single visit, including otolaryngology.
Dr. Thomas Kidder provides this service for Children's Hospital. This approach simplifies medical care for these patients and their families.
Drooling Management Clinic
The multi-disciplinary drooling management clinic at Children's Hospital of Wisconsin meets on a monthly basis and provides a complete assessment of all the factors that may contribute to chronic drooling. These patients are evaluated by a pediatric otolaryngologist, Dr. Stephen Conley. This combined clinic visit helps to simplify care for the patients and their families.
Maxillofacial Trauma Clinic
Children's Hospital of Wisconsin is the only Level I Pediatric Trauma Center in Wisconsin and the Pediatric Otolaryngology Service participates in providing care for patients with maxillofacial injuries