Operation airway: the first sustainable, multidisciplinary, pediatric airway surgical mission.
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/).


CONCLUSIONS
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.
Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Derek J
DJ
Rogers
Pediatric Anesthesiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Corey
C
Collins
Pediatric Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA.
Ryan
R
Carroll
Pediatric Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA.
Phoebe
P
Yager
Pediatric Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA.
Brian
B
Cummings
Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Nikhila
N
Raol
Pediatric Otolaryngology, Yale-New Haven Hospital, New Haven, Connecticut, USA.
Jennifer
J
Setlur
Pediatric Otolaryngology, Brook Army Medical Center, San Antonio, Texas, USA.
Stephen
S
Maturo
Speech-Language Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Sarah
S
Tremblay
Surgery, Metropolitan Hospital, Quito, Ecuador.
Ernesto
E
Quinones
Pediatric Critical Care, Massachusetts General Hospital, Boston, Massachusetts, USA.
Natan
N
Noviski
Pediatric Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Christopher_Hartnick@meei.harvard.edu.
Christopher J
CJ
Hartnick
D000293:Adolescent; D058109:Airway Management; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004484:Ecuador; D006801:Humans; D007223:Infant; D008493:Medical Missions / Q000458:organization & administration*; D010036:Otolaryngology; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics; D015397:Program Evaluation; D011446:Prospective Studies; D055815:Young Adult
Operation Airway; mission; pediatric; surgical