Characteristics of Functional Dysphonia in Children

Functional dysphonia refers to a voice disorder without organic laryngeal disease. In this article, the clinical features and therapeutic strategies of functional dysphonia in children were investigated.

Retrospective analysis of 595 cases of children with dysphonia 3-18 years of age, including 42 patients diagnosed with functional dysphonia. The patients were distributed by age into four groups:3-6, 7-10, 11-14, 15-18 years. The clinical features, laryngeal signs, voice characteristics, pediatric voice handicap index, and therapeutic effects were analyzed.

In this study, 7.1% of the patients were struck with functional dysphonia. 7 (16.7%) patients aged 7-10 years, 16 (38.1%) aged 11-14 years, and 19 (45.3%) patients aged 15-18 years, and there were 23 males and 19 females. Thirteen (31.0%) patients had no cause identified, while some were triggered by upper respiratory tract infection (16 cases, 38.1%), voice overuse (9 cases, 21.4%), or other factors (4 cases, 9.5%). Thirty-four (80.9%) patients had prominent hoarseness, with aphonia in 25 (73.5%) patients, and other 7 (16.7%) patients (15-18 years) showed vocal breaks or vocal effort (4 patients), and high pitch or pitch instability (3 patients). Some patients were accompanied by reduced mucosal waves, supraglottic compensations, and glottal insufficiency. Twelve patients received voice therapy, and their voice was improved after treatment.

In our study, functional dysphonia characterized 7.1% of the patients with voice disorders in children. All patients were 7-18 years of age, particularly 11-18 years. The main triggers of the disorder were upper respiratory tract infection, unknown and voice overuse. Other than apparent hoarseness, some 15-18 years patients experienced vocal breaks, vocal effort, or abnormal pitch. Supraglottic compensations and glottal insufficiency were observed in more than half of the patients. Symptomatic voice therapy obtained significant effects.