Prevalence of Voice Disturbances in the Pediatric Craniofacial Patient Population. (June 2016)

• Record Type: Journal Article
• Authors: Fritz, Mark A.; Rickert, Scott M.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 154:Number 6(2016:Jun.)
• Page Start: 1128
• Page End: 1131
• Publication Date: 2016-06
• Subjects: pediatrics -- otolaryngology -- pVHI -- craniofacial -- dysphonia -- velopharyngeal insufficiency -- resonance disorder -- voice disturbance; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599816639240
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To report on the prevalence of voice disturbances in the pediatric craniofacial population and to prove that the pediatric Voice Handicap Index (pVHI) is a useful questionnaire for this unique population. Study Design: Case series with chart review. Setting: Tertiary care center. Subjects: Pediatric patients seen by a pediatric otolaryngologist in a craniofacial clinic. Methods: Consecutive patients (N = 366) seen by a single pediatric otolaryngologist in a craniofacial clinic from July 2011 to September 2012 were included. Any patient specifically referred for airway problems or voice difficulties completed a pVHI questionnaire. Patients each underwent an evaluation including flexible fiberoptic laryngoscopy and videostroboscopy. Voice disturbance was further characterized into dysphonia, hypernasality, or hyponasality. Results: Of all the patients evaluated, 280 (77%) were specifically referred for airway problems or voice disturbance. Of those referred, 39 (10.7%) were found to have an organic vocal fold pathology causing dysphonia, as seen on the videostroboscopic examination; 53.7% of these lesions were attributable to potential iatrogenic causes. Hypernasality and hyponasality were seen in 116 (31.7%) and 78 (21.3%) patients, respectively. The pVHI was 3.95, 26.3, 11.34, and 10.53 for those with no voice disturbance, dysphonia, hypernasality, and hyponasality, respectively. Conclusion: Pediatric patients with craniofacial disorders have a higher prevalence of dysphonia than the general pediatric population. The majority of causes of dysphonia in these patients are possibly iatrogenic in origin. The pVHI serves as a useful questionnaire in this unique patient cohort to quantify the disability from not only dysphonia but also hypernasality and hyponasality.