Dysphonia in childhood. Experience of personal observations

Introduction. The voice is a basic component for the successful and comprehensive development of a child's personality, the formation of his character and the formation of certain behavioral characteristics. Voice defects can in the future become an obstacle to the chosen specialty, which is extremely important in the professional orientation of a teenager. Dysphonia in children is not a temporary problem, it requires close attention from parents, teachers and doctors, high-quality diagnostics taking into account age characteristics, as well as the selection of optimal treatment for the purpose of rehabilitating the voice function and creating conditions for the comprehensive development of the child. Objective. To assess the nature of laryngeal pathology in children and adolescents at an outpatient appointment with an otolaryngologist-phoniatrist, to analyze the factors influencing the effectiveness of rehabilitation measures. Materials and methods. The study included 97 children and adolescents aged 5 to 17 years inclusive. A comprehensive examination of patients included history, assessment of complaints, voice condition, quality of life, ENT examination using endoscopic equipment. Voice quality was assessed subjectively using the GRBAS scale. Voice Handicap Index (VHI) questionnaire was used to assess the quality of life. Results. The identified laryngeal pathology in children was characterized by a variety of functional and organic changes: mutation (48), vocal fold nodules (37), vocal fold cysts (2), vocal fold polyp (1), neurogenic and myogenic laryngeal paresis (6), contact granuloma (1), chronic laryngitis (2). The most common comorbid pathologies were adenoid (78.4 % of children), allergic rhinitis (23.7 %), chronic tonsillitis, tonsil’s hypertrophy (47.4 %), and gastroesophageal reflux (12.4 %). The highest GRBAS values were recorded in children with chronic laryngitis and larynx contact granuloma. The worst quality of life indicators was demonstrated by children with vocal fold paralysis. The most non-compliant with respect to treatment and dynamic observation were children with vocal fold nodules. Conclusions. The most common causes of dysphonia in children are mutation (49.5 %) and vocal fold nodules (38.1 %). In most cases, parents do not initiate a visit to a specialist of voice disorders, since they either do not notice the problems that arise in the child due to voice disorders or do not focus on them. The effectiveness of rehabilitation measures depends on the patient's compliance.