HOARSENESS AMONG SCHOOL-AGE CHILDREN
Background. The prevalence of dysphonia in schoolchildren has been reported to be from 7.1% to 23.3% and in adolescents from 0 to 80%. In Slovenia, the study on prevalence of dysphonia in schoolchildren has not been performed yet.
Methods. The voice samples of 100 4th-graders and 102 8thgraders of elementary school were recorded. A lay judge and a professional assessed independently degree of hoarseness in the voice samples. One to three months after the recording, the dysphonic children were invited to an otorhinolaryngologic examination in order to find out the cause of dysphonia. All children and their parents answered the questionnaires on illnesses and vocal habits that might cause hoarseness. The prevalence of these unfavourable factors was compared between the group of children with long lasting hoarseness and the children without it.
Results. At voice samples’ recording there were 34.2% dysphonic children. One to three months later, there were still 14.9% children with hoarse voice. The most frequent causes for acute dysphonia were acute respiratory infection and exacerbation of chronic laryngitis. The most frequent causes for persistent dysphonia were allergic catarrhal laryngitis, muscle tension dysphonia with or without vocal nodules and mutational voice disorder. The fast speaking rate appeared to be characteristic for children with long lasting dysphonia.
Conclusions. Dysphonia in school-age children is the result of diseases of upper respiratory tract and/or functional voice disorders. Both causes of dysphonia could be successfully treated if they are detected early and the children are advised to see an otorhinolaryngologist. Adolescence is an ideal period for treatment of functional voice disorders. It is also the period when the children must decide for their future profession.
Kambič V, Gale N, Radšel Z, Žargi M. Predgovor. In: Hripavost. 1. izdaja. Ljubljana: Lek, 1986: 3–4.
Wilson K. Voice disorders in children. 3rd ed. Baltimore: Williams & Wilkins, 1987: 1–3, 51–2, 229–33.
Hersan R, Behlau M. Behavioral management of pediatric dysphonia. Otolaryngol Clin North Am 2000; 33: 1097–109.
Hočevar-Boltežar I. Pomen videoendostroboskopije v diagnostiki bolezni grla. Zbornik simpozija kirurgija vratu; 2001, Ljubljana, Slovenija. Ljubljana: Klinični oddelek za torakalno kirurgijo in Klinika za otorinolaringologijo in cervikofacialno kirurgijo Kliničnega centra Ljubljana, 2001.
Kambič V, Gale N, Radšel Z, Žargi M. Zamejene benigne hiperplastične spremembe. In: Hripavost. 1.izdaja. Ljubljana: Lek, 1986: 29–37.
Koufman JA, Isaacson G. The spectrum of vocal disfunction. Otolaryngol Clin North Am 1991; 24: 985–8.
Koufman JA, Blalock PD. Classification and approach to patients with functional voice disorders. Ann Otol Rhinol Laryngol 1982; 91: 372–7.
Hočevar-Boltežar I. Funkcionalna disfonija. Zdrav Var 2001; 40: 254–7.
Child DR, Johnson TS. Preventable and nonpreventable causes of voice disorders. Semin Speech Lang 1991; 12: 1–12.
Sataloff RT, Spiegel JR. Care of professional voice. Otolaryngol Clin North Am 1991; 24: 1093–124.
Spiegel JR, Hawkshaw M, Sataloff RT. Dysphonia related to medical therapy. Otolaryngol Clin North Am 2000; 33: 771–84.
Morrison M, Rammage L, Nichol H, May P, Salkeld L. Psychological management of voice disordered patient. In: The management of voice disorders. 1st ed. San Diego, California: Singular Publishing Group, 1994: 98–109.
Aronson AE. An interdisciplinary approach. In: Clinical voice disorders. 3rd ed. New York: Thieme, 1990: 117–45.
Roy N, Bless DM, Heisey D. Personality and voice disorders: a superfactor trait analysis. J Speech Lang Hear Res 2000; 43: 749–68.
Radšel Z, Žargi M, Hočevar-Boltežar I. Hripavost v šolskem obdobju – preprečevanje in poklicno usmerjanje. Zbornik I. kongresa šolske in visokošolske medicine Slovenije, 4.–5. junij 1993, Radenci, Slovenija. Ljubljana: Inštitut za varovanje zdravja RS, 1994.
Dejonckere PH. Pathogenesis of voice disorders in childhood. Acta Otorhinolaryngol Belg 1984; 38: 307–14.
Dobres R, Lee L, Stemple JC, Kummer AW, Kretschmer LW. Description of laryngeal pathologies in children evaluated by otolaryngologists. Journal of Speech and Hearing Disorders 1990; 55: 526–32.
Baynes RA. An incidence study of chronic hoarseness among children. Journal of Speech and Hearing Disorders 1966; 31: 172–6.
Silverman EM, Zimmer CH. Incidence of chronic hoarseness in among school-age children. Journal of Speech and Hearing Disorders 1975; 40: 211–5.
Senturia DH, Wilson FB. Otorhinolaryngologic findings in children with voice deviations. Ann Otol Rhinol Laryngol 1968; 77: 1–15.
Curry ET. Hoarseness and voice change in male adolescents. J Speech Dis 1949; 14: 23–9.
Krejović B, Janošević L, Stanković P, Janošević S. Inflammatory causes of dysphonias in childhood. Proceedings of the 3rd European Congress of the European Federation of Oto-Rhino-Laryngological Societies; 1996, June 9–14; Budapest, Hungary. Bologna: Monduzzi Editore S.p.A., 1996.
Kambič V, Radšel Z, Gale N. Hripavost pri otrocih – posledica vnetja. Zdrav Vestn 1989; 58: 417–8.
Yairi E, Currin LH, Bulian N, Yairi J. Incidence of hoarseness in school children over a one year period. J Commun Dis 1974; 7: 321–8.
Casper M, Abramson AL, Franco BF. Hoarseness in children: summer camp study. International Journal of Pediatric Otorhinolaryngology 1981; 3: 85– 9.
Mušič E, Furlan J, Rus A. Diagnostika alergijskih bolezni. Zdrav Vestn 1993; 62: 535–40.
Kay AB, Lessof MH. Allergy conventional and alternative concepts. Clin Ann Experiment Allergy 1992; 22: Suppl 3: 1–5.
Sederholm E, McAllister A, Dalkvist J, Sundberg J. Aetiologic factors associated with hoarseness in ten-year-old children. Folia Phoniatr Logop 1995; 47: 262–78.
Morrison M, Rammage L, Nichol H, May P, Salkeld L. Anatomy and physiology of voice production. In: The management of voice disorders. 1st ed. San Diego, California: Singular Publishing Group, 1994: 161–200.
Kahane JC. A morphological study of human prepubertal and pubertal larynx. Am J Anat 1978; 151: 11–20
Ballenger JJ. Diseases of the nose, throat and ear. Philadelphia: Lea & Febiger, 1969.
Aronson AE. Normal voice development. In: Clinical voice disorders. 3rd ed. New York: Thieme, 1990: 39–51.