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Semin Speech Lang 2013; 34(02): 063-070
DOI: 10.1055/s-0033-1342977
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Care of the Child's Voice: A Pediatric Otolaryngologist's Perspective

Marshall E. Smith
1   Division of Otolaryngology/Head and Neck Surgery, Primary Children's Medical Center
2   Center for Voice, Airway, and Swallowing, University of Utah School of Medicine, Salt Lake City, Utah
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Publication History

Publication Date:
30 April 2013 (online)

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Abstract

Children with voice problems are encountered by speech-language pathologists working in schools but not with sufficient frequency to yield a great experience in managing them. Their evaluation and treatment now are best handled by a team of specialists in pediatric otolaryngology and speech-language pathology with expertise in voice and resonance disorders. The voice team uses a variety of assessment tools, including perceptual, parent- and patient-based, instrumental, and imaging measures. The most important component of the diagnostic assessment is laryngoscopy in the awake child, to visualize the vocal folds while the child phonates. This review covers the pediatric otolaryngologist's approach to dysphonia in children. The common causes of dysphonia are reviewed, including vocal nodules and other lesions, reflux laryngitis, laryngeal paralysis, congenital glottic webs, laryngeal papillomatosis, functional voice disorders, and velopharyngeal incompetence. Current treatment options are continually being modified. These are discussed by highlighting recently published research.

Keywords

Pediatric voice - dysphonia - voice clinic
 

  • References

  • 1 Smith ME, Gray SD. Voice. In: Bluestone CD, Stool SE, Alper C, Arjmand E, Casselbrant M, Dohar J, Yellon R, , eds. Pediatric Otolaryngology, 4th ed. Philadelphia, PA: W.B. Saunders; 2003: 1421-1435
    Google Scholar
  • 2 Carding PN, Roulstone S, Northstone K, Team AS. ALSPAC Study Team. The prevalence of childhood dysphonia: a cross-sectional study. J Voice 2006; 20: 623-630
    CrossrefPubMedGoogle Scholar
  • 3 Lee L, Stemple JC, Glaze L, Kelchner LN. Quick screen for voice and supplementary documents for identifying pediatric voice disorders. Lang Speech Hear Serv Sch 2004; 35: 308-319
    CrossrefPubMedGoogle Scholar
  • 4 Leeper L. Diagnostic examination of children with voice disorders: a low-cost solution. Lang Speech Hear Serv Sch 1992; 23: 353-360
    PubMedGoogle Scholar
  • 5 Wilson DK. Voice Problems in Children, 3rd ed. Baltimore, MD: Williams & Wilkins; 1987
    Google Scholar
  • 6 Akif Kiliç M, Okur E, Yildirim I, Güzelsoy S. The prevalence of vocal fold nodules in school age children. Int J Pediatr Otorhinolaryngol 2004; 68: 409-412
    CrossrefPubMedGoogle Scholar
  • 7 Roy N, Bless DM. Personality traits and psychological factors in voice pathology: a foundation for future research. J Speech Lang Hear Res 2000; 43: 737-748
    PubMedGoogle Scholar
  • 8 Lass NJ, Ruscello DM, Bradshaw KH, Blankenship BL. Adolescents' perceptions of normal and voice-disordered children. J Commun Disord 1991; 24: 267-274
    CrossrefPubMedGoogle Scholar
  • 9 Blood GW, Mahan BW, Hyman M. Judging personality and appearance from voice disorders. J Commun Disord 1979; 12: 63-67
    CrossrefPubMedGoogle Scholar
  • 10 Fox News. Prosecutors say Colorado teen confesses in death of Jessica Ridgeway. Available at: www.foxnews.com/us/2012/10/25/teenager-accused-in-colo-girl-abduction-death-former-classmate-says-studied/ . Accessed February 8, 2013
    PubMedGoogle Scholar
  • 11 Campbell TF, Stool S. Principles of Assessment of the Child with a Voice Disorder. Pittsburgh, PA: University of Pittsburgh School of Medicine; 1993
    Google Scholar
  • 12 Gherson S, Wilson Arboleda BM. The speech pathologist's role in the evaluation of the child with a voice disorder. In: Hartnick CJ, Boseley ME, , eds. Pediatric Voice Disorders. San Diego, CA: Plural Publishing; 2008: 77-104
    Google Scholar
  • 13 Wilson DK. Voice Problems in Children, 3rd ed. Baltimore, MD: Williams & Wilkins; 1987
    Google Scholar
  • 14 Maddern BR, Campbell TF, Stool S. Pediatric voice disorders. Otolaryngol Clin North Am 1991; 24: 1125-1140
    PubMedGoogle Scholar
  • 15 Franco RA, Andrus JG, Sataloff RT. New technologies: high-speed video, videokymography, optical coherence tomography, and 3D holography. In: Hartnick CJ, Boseley ME, , eds. Pediatric Voice Disorders. San Diego, CA: Plural Publishing; 2008: 31-50
    Google Scholar
  • 16 Gray SD, Hammond E, Hanson DF. Benign pathologic responses of the larynx. Ann Otol Rhinol Laryngol 1995; 104: 13-18
    PubMedGoogle Scholar
  • 17 Mori K. Vocal fold nodules in children: preferable therapy. Int J Pediatr Otorhinolaryngol 1999; 49 (Suppl. 01) S303-S306
    CrossrefPubMedGoogle Scholar
  • 18 De Bodt MS, Ketelslagers K, Peeters T , et al. Evolution of vocal fold nodules from childhood to adolescence. J Voice 2007; 21: 151-156
    CrossrefPubMedGoogle Scholar
  • 19 Bouchayer M, Cornut G. Microsurgical treatment of benign vocal fold lesions: indications, technique, results. Folia Phoniatr (Basel) 1992; 44: 155-184
    CrossrefPubMedGoogle Scholar
  • 20 Benjamin B, Croxson G. Vocal nodules in children. Ann Otol Rhinol Laryngol 1987; 96: 530-533
    PubMedGoogle Scholar
  • 21 McMurray JS. Benign lesions of the pediatric vocal folds: nodules, webs, and cysts. In: Hartnick CJ, Boseley ME, , eds. Pediatric Voice Disorders. San Diego, CA: Plural Publishing; 2008: 171-189
    Google Scholar
  • 22 Shah RK, Feldman HA, Nuss RC. A grading scale for pediatric vocal fold nodules. Otolaryngol Head Neck Surg 2007; 136: 193-197
    CrossrefPubMedGoogle Scholar
  • 23 Halstead LA. Role of gastroesophageal reflux in pediatric upper airway disorders. Otolaryngol Head Neck Surg 1999; 120: 208-214
    CrossrefPubMedGoogle Scholar
  • 24 Mandell DL, Kay DJ, Dohar JE, Yellon RF. Lack of association between esophageal biopsy, bronchoalveolar lavage, and endoscopy findings in hoarse children. Arch Otolaryngol Head Neck Surg 2004; 130: 1293-1297
    CrossrefPubMedGoogle Scholar
  • 25 Shah RK, Woodnorth GH, Glynn A, Nuss RC. Pediatric vocal nodules: correlation with perceptual voice analysis. Int J Pediatr Otorhinolaryngol 2004; 68: 409-412
    CrossrefPubMedGoogle Scholar
  • 26 Smith ME. Vocal fold paralysis in children. In: Sulica L, Blitzer A, , eds. Vocal Fold Paralysis. New York, NY: Berlin-Heidelberg; 2006: 225-235
    CrossrefGoogle Scholar
  • 27 Smith ME. Pediatric ansa cervicalis to recurrent laryngeal nerve anastomosis. In: Hartnick CJ, Hansen M, Gallagher TQ, , eds. Pediatric Airway Surgery. Adv Otorhinolaryngol. Vol. 73. Basel, Switzerland: Karger; 2012: 80-85
    CrossrefGoogle Scholar
  • 28 Røksund OD, Clemm H, Heimdal JH , et al. Left vocal cord paralysis after extreme preterm birth, a new clinical scenario in adults. Pediatrics 2010; 126: e1569-e1577
    CrossrefPubMedGoogle Scholar
  • 29 Smith ME, Roy N, Stoddard K. Ansa-RLN reinnervation for unilateral vocal fold paralysis in adolescents and young adults. Int J Pediatr Otorhinolaryngol 2008; 72: 1311-1316
    CrossrefPubMedGoogle Scholar
  • 30 Smith ME, Roy N, Houtz D. Laryngeal reinnervation for paralytic dysphonia in children younger than 10 years. Arch Otolaryngol Head Neck Surg 2012; 138: 1161-1166
    CrossrefPubMedGoogle Scholar
  • 31 Zur KB. Recurrent laryngeal nerve reinnervation for unilateral vocal fold immobility in children. Laryngoscope 2012; 122 (Suppl. 04) S82-S83
    CrossrefPubMedGoogle Scholar
  • 32 Setlur J, Hartnick CJ. Management of unilateral true vocal cord paralysis in children. Curr Opin Otolaryngol Head Neck Surg 2012; 20: 497-501
    CrossrefPubMedGoogle Scholar
  • 33 Patterson MB, Pransky SM. Managing juvenile recurrent respiratory papillomatosis and care of the voice. In: Hartnick CJ, Boseley ME, , eds. Pediatric Voice Disorders. San Diego, CA: Plural Publishing; 2008: 191-204
    Google Scholar
  • 34 Smith ME, Roy N, Sauder C. Functional and spasmodic dysphonias in children. In: Hartnick CJ, Boseley ME, , eds. Pediatric Voice Disorders. San Diego, CA: Plural Publishing; 2008: 241-251
    Google Scholar
  • 35 Smith ME, Gray SD, Zimmerman JP. Velopharyngeal inadequacy. In: Papel ID, Nachlas N, Sykes J, , et al, eds. Facial Plastic and Reconstructive Surgery, 2nd ed. New York, NY: Thieme; 2002: 873-888
    Google Scholar
  • 36 Muntz HR, Smith ME, Sauder C, Velopharyngeal dysfunction. In: Flint PW, Haughey BH, Richardson MA, Robbins KT, Thomas JR. , eds. Otolaryngology-Head and Neck Surgery, 5th ed. Vol. 3. Philadelphia, PA: Elsevier Mosby; 2010: 2676-2685
    CrossrefGoogle Scholar