Ep. 132 Challenges and Innovations in Pediatric Dysphagia Management with Dr. Nikhila Raol

In this episode of BackTable ENT, Dr. Gopi Shah and Dr. Nikhila Raol, pediatric otolaryngologist at Children’s Healthcare of Atlanta and Associate Professor at Emory University, discuss management of pediatric dysphagia. --- SHOW NOTES First, Nikhila explains her educational background, starting from training in Texas to going to Atlanta to join Children’s Healthcare of Atlanta. Previously, she spent time in Boston getting her Masters of Public Health because she wanted to develop a niche focused on population health. This degree then sparked the idea of focusing on swallowing disorders in the pediatric population. Then, Nikhila delves into how a child with dysphagia usually presents. These children typically have issues with breastfeeding, coughing, choking, and may even refuse food. In older children, they usually bring forth issues to their parents to prompt evaluation. Red flags to pay attention to in young children with dysphagia include weight loss and significant nasal congestion. Next, Nikhila and Gopi discuss physical examination including evaluation of latch, tongue tie, nasal cavity and Nikhila’s tips for performing a FEES (Fiberoptic Endoscopic Evaluation of Swallow) in infants. Nikhila also mentions the value of having an SLP (Speech Language Pathologist) for every patient with dysphagia and involving GI colleagues to broaden her workup of complicated patients. The episode concludes with a discussion on how to choose between various treatment modalities such as injection or repair of a laryngeal cleft, and Nikhila’s Fulbright project happening in India.