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The human larynx, often referred to as the voice box, is an intricate organ located in the neck. It serves as a pathway for air to enter the lungs during respiration and is an essential component of voice production.
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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
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Pediatric Dysphonia: When to Refer.

Anne F Hseu1,2, Grant P Spencer1, Stacy Jo1

  • 1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.

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PubMed
Summary

Pediatric voice disorders are common, with referrals to specialists recommended for children with dysphonia lasting over 3 months or more severe symptoms. This study guides appropriate referrals for pediatric voice conditions.

Keywords:
children or pediatricsdysphoniahoarsenessvocal fold nodulesvoicevoice therapy

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Area of Science:

  • Otolaryngology
  • Pediatric Voice Disorders

Background:

  • Voice disorders affect a significant portion of the pediatric population, with prevalence estimates varying widely.
  • Not all children experiencing dysphonia receive timely referrals to specialized voice care.

Purpose of the Study:

  • To investigate the correlation between dysphonia history, voice assessment outcomes, and laryngeal findings in children.
  • To establish criteria for guiding referrals of pediatric patients with dysphonia to voice specialists.

Main Methods:

  • Retrospective analysis of pediatric patients (n=459) evaluated at a tertiary voice clinic from 2014-2017.
  • Collected and analyzed demographic data, comorbidities, symptoms, laryngeal examination findings, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores, and Pediatric Voice Handicap Index (pVHI) scores.

Main Results:

  • Males presented more frequently and at a younger age, with higher average CAPE-V Overall Severity, Roughness, and Strain scores.
  • Longer symptom duration and diagnoses such as vocal fold movement impairment or benign lesions (excluding nodules) correlated with higher CAPE-V Overall Severity scores.
  • Patients recommended for intervention showed significantly higher CAPE-V Overall Severity scores compared to those recommended for observation.

Conclusions:

  • Referrals to pediatric voice clinics are warranted for children with a history of dysphonia exceeding 3 months.
  • Referrals should also be considered for children presenting with more severe dysphonia symptoms, as indicated by perceptual voice assessments.