Hoarseness in children

Paediatric Otolaryngology

Does your child have hoarseness at the moment?

We would like to help you understand more about "Hoarseness in Children". And if you want to bring your child to see an ENT specialist to double check the symptoms, let us know.

Professor Havas is one of the few specialists who has post-fellowship training in Paediatrics, leading university affiliations and public hospital appointments. Please Give us a call or use the booking form to arrange the appointment!

Hoarseness in children is rarely due to anatomical problems. In the vast majority of cases, it is due to excessive shouting or straining, that is to say, how the voice box and vocal cords are used as oppose to any anatomical abnormalities.

Hoarseness in Children

First line diagnosis involves perceptual analysis and observation of the pattern of voice use.

The larynx of children is difficult to examine, as it requires a cooperative child who is confident enough to allow a relatively painless but invasive procedure to be undertaken. The optimal way to assess the larynx is to perform flexible endoscopy, in the awake child, under local anaesthetic. This involves spraying a small amount of local anaesthetic into the nostril, and after it has had time to work, introducing a small flexible endoscope either with a camera attached so the child and parents can see what’s happening, or naked eye, to observe structures at the back of the nose, back of the tongue, epiglottis, and voice box, both at rest, during quiet breathing, and during talking and singing.

Most children over the age of five, after appropriate explanation, can tolerate this procedure, but under the age of five, it is sometimes difficult.

The most common cause of hoarseness in children is the presence of vocal nodules. Vocal nodules are like callouses on the vocal folds due to excessive shouting or screaming. They are appropriately treated by reassurance and alteration of vocal habit. If the child alters their pattern of speaking and shouting, the callouses go away. The reverse of this, that even if the callouses are removed (as used to be the case hitherto) unless the pattern of vocal usage is significantly altered they will recur.

Vocal nodules are never dangerous. They never grow and obstruct the airway. They never turn into anything nasty.

If any doubt exists about the presence of a congenital, structural, or infective lesion (such as warts or papilloma in the voice box), formal examination under general anaesthesia is appropriately undertaken. Please contact Havas ENT Clinics on (02) 9387 7360. One of our friendly clinic assistants will be able to make you an appointment with Professor Havas.