Laurie Barclay, MD NEW YORK (MedscapeWire) May 14
Although conventional wisdom suggests vocal cord nodules are the most common cause of chronic hoarseness in children, laryngeal reflux is more likely to blame, and laryngeal examination helps detect often-missed diagnoses, according to a May 12 presentation at the annual meeting of the American Broncho-Esophagalogical Association. If properly diagnosed and treated, vocal quality improves in most patients.
“Chronic hoarseness in the pediatric population is likely increasing,” write Vito Brunetti and colleagues from the State University of New York at Buffalo.
“Recognition may be suboptimal as its importance is downplayed by parents and many primary care physicians.”
The researchers compared questionnaire responses about hoarseness and voice completed by 166 parents and 5 attending pediatric otolaryngologists.
Hoarseness was common. It was present in 40 (24%) of 166 children and was the chief complaint in 18 (10.8%) of 166 children.
The otolaryngologist identified another 7 children (4.2%) as having abnormal vocal quality. These children with hoarseness were included in a sample of 877 consecutive patients requiring diagnostic laryngoscopy at a children’s hospital. Laryngeal diagnoses included reflux laryngitis in 165 (73%) of 227 children, true vocal fold nodules in 70 children (30.8%), and laryngomalacia in 33 children (14.5%).
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