Pediatric voice center
Children can develop problems with their voice. The most common symptom of a vocal cord problem is hoarseness or breathiness. The pediatric voice center was established to help children and their families evaluate, diagnose, and treat problems of pediatric voice disorders.
What are voice problems in children?
Voice and speech are not the same thing. Voice problems are difficulties with sound production, not with formation of words. Most of these problems originate in the larynx (“voice box”) and are characterized by a hoarse voice in children or a quiet voice.
The causes of voice problems in children include:
- Vocal nodules or polyps
- Vocal cord paralysis
- Laryngeal tumors
- Acid reflux disease
- Papillomas
- Neurologic disease
- Vascular malformations
- Vocal cord webs
- Scarring of the larynx or vocal cords from disease or previous surgery
How are voice problems in children diagnosed?
Most voice problems in children are evaluated using a test called a laryngeal video stroboscopic (LVS) exam. It involves a thin, flexible camera that gently passes through the nose to the back of the throat, allowing specialists to see the vocal cords in motion.
This tool uses a rapidly flashing light to slow down the movement of the vocal cords, helping identify issues like scarring, small growths, or cords that don’t close properly.
The exam takes about 5 to 10 minutes, is done in the office and doesn’t require medication or shots. Unlike adult procedures that use rigid uncomfortable scopes. This method is designed to be tolerable for children.
After the exam, doctors and speech pathologists review the video and recommend the next steps.
What can I and my child expect at our visit?
First you and your child will meet with one of the physicians in our office. The doctor will ask you a number of questions about your child’s voice and discuss your concerns.
An exam at our office will most likely include insertion of a thin, flexible fiberoptic scope down your child’s nose and into the back of the throat. Most children tolerate this procedure very well. In children over 4 years old, exams using the LVS have a 90% first-time success rate for tolerance and high-quality diagnostic information.
Here are the steps of a LVS exam:
- Drops may be put in your child’s nose to help decongest or numb the nasal passage.
- The child may sit alone or on a parent’s lap.
- The scope (about the size of a spaghetti noodle) will be passed through one side of the nose and down the throat. This scope will illuminate the larynx.
- With the child’s vocal cords visible on a TV monitor, he or she will be asked to say certain words and sounds (most frequently “eeeee”).
- The scope will be removed. There is no after-pain. In rare cases, a slight nosebleed may occur.
How are voice problems in children treated?
Depending on the results of your child’s exam, the following treatments might be recommended:
- In-office voice therapy with a speech therapist of your choice.
- At-home voice therapy with a home therapist.
- A more in-depth exam under anesthesia (direct laryngoscopy).
- Surgery on the larynx.
