Pediatric voice disorders
Duke voice care experts specialize in treating children with voice disorders they are born with, that result from vocal misuse or overuse, or are acquired due to a serious medical condition. We have the skill and expertise to work with your child and your family to diagnose vocal disorders, develop a customized treatment plan that includes learning healthy ways to use your voice. We restore your child's voice to the best it can be.
Specialists in children's voice disorders
If your child has a raspy voice, he or she may be experiencing a voice disorder based on overuse or misuse - typically caused by too much loud talking, shouting or constant talking. The misuse can lead to vocal cord polyps, nodules and cysts. Our experts specialize in voice disorders that affect children. We use the latest techniques to evaluate his or her condition and recommend the most age-appropriate treatment, based on their individual condition. Voice disorders in children can result from medical conditions such as allergies, asthma and reflux. You should consider a professional evaluation if your child experiences frequent laryngitis, seems to strain when talking, or complains of a scratchy throat.
Children may be born with voice disorders, or they may result from a serious medical condition. For example, your child may experience vocal cord paralysis if she or he has undergone heart or lung surgery. Or, your child may suffer from other medical conditions, such as a growth on the vocal cord (papilloma), narrowing of the airway (subglottic stenosis), congenital softening of the voice box tissues (laryngomalacia), and a common malformation of the voice box (glottic web). All can affect your child's ability to speak, and cause breathing and swallowing problems. These conditions are treated promptly and effectively by our team of specialists.
Choose Duke for treatment of your child's voice disorders because we offer:
- Specialists in children’s voice problems. Your child's medical team includes laryngologists, speech pathologists and singing specialists who are trained to meet the special needs of children and their families. Laryngologists are ear, nose, and throat (ENT) physicians who undergo advanced training in voice disorders. Our laryngologists are highly skilled at complex pediatric surgeries involving the voice box. A child’s voice box is different from an adult's. Our laryngologists' special expertise is needed to ensure your child receives appropriate treatment for their stage of development.
- Speech pathologists and singing voice specialists. Our speech pathologists undergo specialized training to evaluate and treat children and adults with voice problems, swallowing disorders, and complex conditions. Our team also includes trained singing voice specialists. They are experienced performers, singers, and singing teachers who understand the special needs of the young singer and the challenges of being a vocal professional. Our singing voice specialists bring empathy, clinical expertise, and an insider perspective to evaluating and improving your child’s vocal health. They also provide specialized therapy to performers and singers, both adults and children.
- Coordinated care. Voice disorders may result from a variety of medical conditions, including allergies and asthma. We coordinate your child's care with the right specialists throughout our health system to ensure he or she receives the best therapies to minimize their symptoms, improve their voice, and optimize their recovery.
- Treatment for all laryngeal conditions. The voice box, or larynx, is responsible for your voice, your ability to swallow, and your airway or breathing passage. Our doctors and speech pathologists treat voice, upper airway breathing and swallowing problems.
- Better treatment decisions. Our ongoing research ensures your child receives the best care for their voice disorder.
PEDIATRIC VOICE DISORDERS
Improves your child's speaking voice technique, pacing, and vocal hygiene. Your child works with a speech pathologist who guides them through vocal exercises to improve breathing, reduce throat strain, find their optimal pitch and volume for strong, healthy speaking. We increase awareness about healthy voice use, and encourage avoidance of harmful vocal behaviors such as yelling and screaming. Treating your child involves the whole family in order to implement good strategies at home.
Tiny surgical instruments inserted through the mouth into the throat are used under magnification to remove noncancerous vocal cysts and vocal polyps under general anesthesia. A very small incision is made away from the vibrating edge of the vocal cord, and a “microflap” of tissue is lifted so the cyst or polyp can be removed. Also known as “phonomicrosurgery,” this technique reduces the risk of scarring following surgery, and promotes best voice outcomes. Voice rehabilitation after microsurgery is essential for best recovery.
An implant (like a tiny shim) is placed through the voice box to reposition the paralyzed vocal cord and produce a stronger voice. Also known as "medialization laryngoplasty" or "laryngeal framework surgery,” this procedure requires a small incision in the neck. Thyroplasty is often recommended when vocal cord paralysis appears permanent and the voice is very weak and breathy.
Injectable fillers plump up the vocal cords when they have lost muscle tone or bulk due to vocal cord paralysis. This procedure creates a stronger voice. A tiny needle loaded with Cymetra or Gelfoam is inserted via a tiny tube through the nose into the throat, so the vocal cords can be injected.
Surgically reconnects a nerve to the weakened vocal cord muscle. This restores the vocal cords' tone and bulk, which makes the voice stronger. Full results can take two to six months. Also known as “ansa to recurrent nerve reinnervation,” since it uses the ansa cervicalis neck muscle.
A surgical procedure to reconstruct the trachea when it becomes narrowed, a condition called tracheal stenosis.
PEDIATRIC VOICE DISORDERS
Assesses your child's voice use patterns - how much they speak, sing, or use a loud voice, and what their voice sounds like. Your child's laryngologist will evaluate the role of any medical conditions that can cause voice changes, such as surgeries and recent illness. If chronic cough is a concern, your child's breathing or cough symptoms and other triggers will be evaluated. A head and neck examination is performed. A visual examination of the voice box is also completed.
This visual exam evaluates how your child's vocal cords vibrate while they make sounds. A tiny camera attached to a small tube called an endoscope is inserted through the nose to the top of the throat. This camera uses a flashing strobe light to capture slow motion images of the vocal cords. The images are analyzed to reveal growths, stiffness, paralysis, irregular movements, throat strain, and incomplete closure of the vocal cords. Videostroboscopy is often essential to reach an accurate voice diagnosis.
Creates a visual display on a computer screen as your child speaks into a microphone. Allows your speech pathologist to see characteristics of your child's voice, including pitch, loudness, and vocal quality (including hoarseness and breathy voice). It is used to identify abnormalities, including subtle vocal problems that cannot be detected with the unaided ear. It may be repeated during treatment to monitor your child's progress.
May be used to evaluate the voice box nerves and muscles by analyzing their electrical activity. As your child lies on his or her back, small, thin electrode needles are placed in the neck muscles that move the vocal cords. You are asked to make sounds to activate each muscle being tested. The results are used to diagnose and evaluate vocal cord paralysis.