The chief complaint of patients in an inner city pediatric voice clinic is hoarseness, which is also a common and widespread vocal health issue.
In a paper presented at the 2009 American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting & OTO EXPO in San Diego, researchers evaluated a database of voice patients from August 2003 to June 2008 in a tertiary care children's hospital voice clinic. Data were reviewed for demographics, medical history, voice analysis, treatment, and prevalence of vocal pathologies.
A total of 227 patients were studied. Mean age was 7 years; 53 percent were male. Of the 317 diagnoses made, they included: vocal nodules (42 %), gastroesophageal reflux (10%), hyperfunction (6 %), velo-pharyngeal insufficiency (5 %), and edema (5 %), and no pathology (7%). Sixty-six percent had a chief complaint of hoarseness and 77 percent of these had vocal nodules.
The authors noted that 23 percent of patients with vocal nodules did not present with a complaint of hoarseness, but presented with other subjective complaints. Thus, in a quarter of the patients, vocal nodules presented with other symptoms than hoarseness. This finding supports the role of laryngeal examination in all pediatric patients with vocal nodules.
Seven percent of patients had no pathology on exam. These patients presented with subjective vocal abnormalities and had a higher mean age (10.29 yrs) compared to those who had pathology. The authors suggested further studies to examine the possible age-related and/or environmental components to their subjective complaints.