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Voice Disorders in Children: Experience in the Voice Unit at Universidad Católica Clinical Hospital
Phoebe Helena Ramos1, Matías Lautaro Álvarez1, Norma Inés León1
1Otolaryngology Department Pontificia Universidad Católica de Chile, Edificio Académico, Dpto. Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago Centro, Santiago, Chile.
Insights
Pediatric dysphonia diagnosis improved with advanced videolaryngostroboscopy (VLS). A multidisciplinary team and VLS are crucial for accurate vocal cord pathology diagnosis in children.
Area of Science:
- Otolaryngology
- Pediatric Voice Disorders
- Laryngeal Imaging
Background:
- Pediatric dysphonia affects 6-23% of children, requiring thorough laryngeal evaluation for accurate diagnosis.
- A wide range of conditions can cause childhood dysphonia, necessitating specialized diagnostic approaches.
Purpose of the Study:
- To detail the diagnostic experience for pediatric dysphonia at a specialized voice unit in Santiago, Chile.
- To analyze diagnostic trends and the impact of evolving laryngeal visualization technologies.
Main Methods:
- Retrospective review of 126 pediatric patients (0-18 years) diagnosed with dysphonia between 2012-2019.
- Evaluation by a specialized multidisciplinary team including Otolaryngologists and a speech therapist.
- Comparison of diagnostic outcomes using flexible fiber-optic laryngoscopy and rigid videolaryngostroboscopy (VLS) versus advanced distal chip VLS technologies.
Main Results:
- Vocal nodules (40%) and vocal cord cysts (26%) were the most common diagnoses.
- The introduction of advanced VLS in the second study period correlated with a decrease in vocal nodule diagnoses and an increase in vocal cord cyst diagnoses.
- The majority of patients were male (54%) with an average age of 9 years.
Conclusions:
- A multidisciplinary expert team and appropriate laryngeal visualization equipment are essential for diagnosing pediatric dysphonia.
- Videolaryngostroboscopy (VLS) is the gold standard for diagnosing vocal cord pathologies in pediatric patients.
Introduction:
Dysphonia in children is a common symptom, its prevalence varies between 6% and 23%. There is a broad differential diagnosis and the recommendation is to evaluate dysphonic children with an adequate laryngeal visualization method to achieve an accurate diagnosis and treatment.
Objective:
To describe the experience in the diagnosis of dysphonia in children in the voice unit at Universidad Católica Clinical Hospital Santiago, Chile.
Methods And Materials:
A retrospective chart review was conducted of all new pediatric patients treated in the voice unit at Universidad Católica Clinical Hospital between 2012 and 2019. Demographic data, diagnosis, and in-office laryngoscopies were reviewed. All patients were evaluated by the same work team consisting of two Otolaryngologists specialized in vocal pathology and a speech voice therapist.
Results:
A total of 126 new pediatric patients between the ages of 0 to 18 years were evaluated in the voice unit at Universidad Católica Clinical Hospital Santiago, Chile. The majority were males (54%) with an average age of 9 years. 40% of the diagnosis corresponded to vocal nodules, 26% to vocal cord cysts, the remaining to a group of less frequent diagnosis. Two different groups were studied, the first group evaluated during the years 2012-2015 with flexible fibre-optic laryngoscopy and rigid videolaryngostroboscopy (VLS); the second group evaluated between the years 2015-2019 with distal chip flexible videolaryngoscopy, distal chip flexible VLS and rigid VLS. In the second group, the diagnosis of vocal nodules decreased, and the diagnosis of vocal cord cysts increased in comparison to the first group.
Conclusion:
Pediatric patients with dysphonia must be evaluated by a multidisciplinary team of experts and adequate equipment. VLS should be considered the gold standard in the diagnosis of vocal cord pathology in pediatric population.
