Dysphonia in Children; Clinical Profile, Conservative Treatment Modalities and Outcomes: An Institutional Experience

Dysphonia in children represents broad-spectrum voice problems. Global prevalence of hoarseness in school-aged children is 6-23%. It impairs communication of child, thus affects social life. This study shows importance of appropriate preventive measures for paediatric dysphonia and diagnosis of voice problems in early stages. Continuous voice abuse in children can cause recurrent voice disorders as well as speech problems. This prospective study included 104 patients(78 males and 26 females) of 6-15 years, with voice problems, in a tertiary care centre, North Kerala, during June 2022-March 2023. Chief complaints and risk factors evaluated. Voice analysis using maximum phonation time (MPT), Child Voice Handicap Index for Parents (CVHI-10-P), Reflux Symptom Index (RSI) and clinical examination including indirect laryngoscopy (IDL) and 70degree scopy were done. Treatment given for a maximum of 2 weeks. Advised voice rest and voice therapy throughout. All patients followed up after 2 weeks and up to 3 months. Voice abuse was the commonest risk factor and voice change, the commonest symptom. MPT reduced in 23% males and 14% females. According to CVHI-10-P, screaming was present in 52% children and symptoms present mostly in afternoon. RSI identified the role of LPRD in dysphonia. IDL and 70 scopy identified most common diagnosis as vocal nodule. Treatment given and follow-up period noted. All except vocal polyp had complete relief. Most common diagnosis was vocal nodule which resulted from chronic voice abuse. Appropriate preventive measures, early diagnosis and adequate treatment of voice problems should be considered. Conservative management in early stages is recommended.