Prevalence of voice disturbances in pediatric airway patients: Are we missing anything?

Publication date: Available online 16 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Anne Hseu, Nohamin Ayele, Natasha Dombrowski, Alex Irace, Kosuke Kawai, Geralyn Woodnorth, Karen Watters, Roger Nuss, Reza Rahbar

Abstract

Objective

To report on the prevalence of voice disturbances in pediatric airway patients.

Methods

Consecutive patients seen in a specialized Center for Airway Disorders at a tertiary children's hospital from February 2017 to September 2017 were included. Patients' families were invited to complete a pediatric voice health handicap index (pVHI) questionnaire. Patients underwent evaluation including flexible laryngoscopy and/or direct laryngoscopy and bronchoscopy.

Results

146 patients were included. Of these children, 73 patients (50.3%) presented with swallowing difficulty and 44 patients (30.3%) presented with respiratory complaints. Only 7 patients (4.8%) reported hoarseness initially. The median age at referral was 2.7 years of age (interquartile range: 1.4-4.3). The mean total pVHI score was 9.5 (± 12.9). Sixty-seven patients (45.9%) had abnormal pVHI findings of score > 4. Six patients (4.1%) had pVHI > 40. The mean pVHI score was 26.0 (± 21.1) among 12 patients with a history of tracheostomy, 12.0 (± 14.3) among 30 patients with laryngeal cleft, and 9.0 (± 9.9) among 19 patients with laryngomalacia.

Conclusion

Voice disturbances are not uncommon in pediatric patients evaluated for airway disorders. Although patients may present with primary concerns for breathing or swallowing difficulties, many of these patients may need further work-up and treatment for dysphonia.

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