ORIGINAL ARTICLE Multidisciplinary approach to paediatric aerodigestive disorders: A single-centre longitudinal observational study Amol Fuladi , 1 Sadasivam Suresh, 1 Rahul Thomas, 1 Matthew Wong, 1 Sandra Schilling, 1 Looi Ee , 2 Kelvin Choo, 3 Christopher Bourke, 3 Craig McBride, 3 Brent I Masters 1,4 and Nitin Kapur 1,4 1 Department of Respiratory and Sleep Medicine, 2 Department of Gastroenterology, Hepatology and Liver Transplant, 3 Department of Paediatric Surgery, Queensland Children’s Hospital and 4 School of Medicine, University of Queensland, Brisbane, Queensland, Australia Aim: Aerodigestive clinics (ADCs) are multidisciplinary programmes for the care of children with complex congenital or acquired conditions affecting breathing, swallowing and growth. Our objective was to describe the demographic, clinical, etiological and investigational profile of chil- dren attending the inaugural ADC at a tertiary paediatric centre in Queensland. Methods: Children referred to the ADC at Queensland Children’s Hospital from August 2018 to December 2019 were included. Data on clinical, growth and lung function parameters, bronchoscopy and upper gastrointestinal endoscopy findings, thoracic imaging and comorbidities were ret- rospectively analysed. Results: Fifty-six children (median (range) age 4 years (3 months–15 years); 18 female) attended the ADC during this 17-month period. Forty-six (82%) children had previous oesophageal atresia with tracheo-oesophageal fistula; 43 of these were type C. Previous isolated oesophageal atresia, congenital diaphragmatic hernia and congenital pulmonary malformation were the underlying disorder in three (5%) children each, with one child having a repaired laryngeal cleft. Vertebral Anal Tracheo Esophageal Renal Limb anomalies (VACTERL)/Vertebral Anal Tracheo Esophageal renal anomalies (VATER) association was seen in 21 (38%) children. Growth was adequate (median weight and body mass index z-score -0.63 and -0.48, respectively). Thirty-four (61%) children reported ongoing wet cough, with 12 (21%) requiring previous hospital admission for lower respira- tory tract infection. Fourteen (25%) had bronchiectasis on computed tomography chest and 33 (59%) had clinical tracheomalacia, apparent on bronchoscopic examination in 21 patients. Dysphagia was reported in 15 (27%) children, 11 (20%) were gastrostomy feed-dependent and 5 (9%) had biopsy-proven eosinophilic oesophagitis. Conclusion: High proportion of children attending the ADC have ongoing respiratory symptoms resulting in chronic pulmonary suppuration and bronchiectasis. Potential benefits of this model of care need to be studied prospectively to better understand the outcomes. Key words: aerodigestive clinic; bronchiectasis; tracheo-oesophageal fistula. What is already known on this topic 1 Aerodigestive programmes are mainly operational in North America. 2 Gastroenterology or Otolaryngology is most often the lead specialty. 3 The patient mix is varied and is governed by the interests of the lead team. What this paper adds 1 This study describes the clinical profile of children attending this inaugural programme in Queensland. 2 Respiratory medicine is the lead specialty at this centre. 3 Lower airway pathology predominated in this cohort, with bron- chiectasis and tracheomalacia being common comorbidities. Providing coordinated system of care to children with special health-care needs (CSHCN) is of paramount importance as these constitute more than 20% of all children requiring health assis- tance. 1 An important sub-group of CSHCN are children pre- senting with complex interrelated respiratory and gastrointestinal (GI) pathology, these disorders are collectively referred to as aerodigestive disorders. 1,2 These can present to different sub- specialities with feeding difficulty, growth failure, chronic cough, recurrent chest infections and noisy breathing and with features suggestive of gastro-oesophageal reflux, oesophagitis, airway malacia, sleep apnoea and chronic suppurative lung diseases. 3–6 The heterogeneity of symptoms in these children requires multi- ple and separate specialty clinic visits over an extended period of time. 5 This can result in carer fatigue and confusion, is more expensive, causes poorer quality of life and may worsen clinical outcomes. 4–7 This warrants for an interdisciplinary coordinated clinic care approach. Many studies have shown that offering a coordinated care to these children in the form of aerodigestive clinic (ADC) not only facilitates the clinical care but also improves Correspondence: Dr Amol Fuladi, Department of Respiratory Medicine, Queensland Children’s Hospital, 501 Stanley Street, South Brisbane, Qld. 4101, Australia. Fax: +61 30682309; email: amolfuladi@rediffmail.com Conflict of interest: None declared. Accepted for publication 9 July 2020. doi:10.1111/jpc.15090 Journal of Paediatrics and Child Health (2020) © 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) 1