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The dysphonic child: diagnostic, treatment and clinical evolution

Vocal nodules are the main cause of dysphonia in children, but through the videolaryngoscopy, others lesions are frequently found in infantile larynx like, cysts, sulcus, anterior commissure microwebs, denominated vocal fold cover minor structural alterations. AIM: To evaluate, in 71 children with dysphonia seen at "Ambulatório de Foniatria da Faculdade de Medicina de Botucatu (Unesp)", during the last five years: sex incidence, age, diagnostic, treatment and clinical evolution. STUDY DESIGN: Clinical retrospective. MATERIAL AND METHOD: We reviewed the evaluations of 71 children with dysphonia, with age range of 3 to 13 years, who underwent otolaryngologic and endoscopic exams (videolaryngoscopy or flexible fiberoptic). The children with functional dysphonia or respiratory distress complaints were excluded. RESULTS: the main diagnoses were: vocal nodules (47 cases; 66,2%), epidermic cysts (7 cases; 9,9%), fistuleted cyst (6 cases; 8,4%), sulcus vocalis (5 cases; 7,1%), vocal fold bridge associated to cyst (2 cases; 2,8%), anterior microwebs associated to nodules (2 cases; 2,8%) and polyps (2 cases; 2,8%). The dysphonias were more frequent in boys (63,3%). The phonotherapy was the preferential treatment to nodules (well clinical evolution), sulcus vocalis (failed therapy) and microweb (failed therapy). The surgery followed by phonotherapy was the treatment in cysts, bridge and polyps, with satisfactory clinical evolution, except in that cases that refused the surgery. CONCLUSION: The vocal nodules are the main cause of dysphonia in children, but the vocal fold cover minor structural alterations are frequently seen in infantile larynx and for these diagnose the exam may be careful.

dysphonia; children; larynx


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