Hoarseness Common Complaint Among Inner City Children


A new study finds that hoarseness is a common complaint among inner city children at pediatric voice clinics. In most cases hoarseness in children is not a serious matter, but it should be evaluated to identify the cause so appropriate treatment can be started.

Hoarseness, also known as dysphonia, is the sound produced when something prevents the vocal folds, which are part of the larynx, from vibrating normally. This can occur for a number of reasons. Masses such as nodules (callous-like), polyps (jelly-like), cysts (blister-like), and papilloma (wart-like growths) can cause hoarseness. These different masses, as well as swelling, can develop as a result of chronic overuse, loud crying, screaming, or yelling. Papillomas can grow on the vocal folds as the result of an infection with the human papilloma virus. Trauma to the neck can damage the voice box (larynx) or cause paralysis of the nerves.

Results of the current study were presented at the 2009 American Academy of Otolaryngology Head and Neck Surgery Foundation Annual Meeting in San Diego. The authors evaluated the data from children (mean age, 7 years) who had visited a pediatric voice clinic from August 2003 to June 2008. Sixty-six percent of the 227 patients studied reported hoarseness as their main complaint, and 77 percent of these patients had vocal nodules.


The clinicians at the clinic made a total of 317 diagnoses over the course of the study period. They included 42 percent vocal nodules, 10 percent gastroestophageal reflux, 6 percent hyperfunction (overuse/abuse of the voice), 5 percent had velo-pharyngeal insufficiency, 5 percent had swelling (edema), and 7 percent had no identifiable pathology. Nearly one-quarter of the children who had vocal nodules did not complain of hoarseness but had other symptoms. The researchers noted that this latter finding supports the importance of conducting an examination of the larynx in children who have vocal nodules.

In the children for whom the clinicians could not find a cause of the hoarseness, the study’s authors suggested that further studies should be conducted to examine possible age-related factors (these children had a greater mean age, 10.2 years, than the other children) and/or environmental components that could explain the children’s complaints.

Generally, any child who experiences sudden hoarseness or who has trouble breathing or swallowing due to injury to the neck should be evaluated immediately by a physician. Children who experience hoarseness for longer than four weeks also should be seen by a laryngologist. Although hoarseness is a common symptom of an upper respiratory tract infection, it should be evaluated by a doctor if it lasts longer than two weeks as it may be caused by mild paresis (partial paralysis) of the vocal folds.

EurekAlert October 4, 2009