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Perceptual voice characteristics in pediatric unilateral vocal fold paralysis.

Shah RK, Harvey-Woodnorth G, Glynn A, Nuss RC

Department of Otorhinolaryngology and Communication Disorders, Children's Hospital Boston, Boston, MA 02115, USA.

OBJECTIVE: To describe the voice characteristics of pediatric unilateral vocal fold paralysis (UVFP). STUDY DESIGN AND SETTING: Retrospective series from a children's hospital, 1996 to present. RESULTS: Forty-two patients with a mean age of 7.1 years were diagnosed with UVFP in our voice clinic (prevalence = 5.4%). Paralysis was left sided in 88%, and was most commonly seen after cardiac surgery (28.5%) and prolonged intubation/prematurity (16.7%). Voice analysis showed a moderate degree of breathiness, mild-to-moderate hoarseness and straining, mild muscle tension, and soft loudness. Twenty-six percent of patients required surgical intervention, including injection into the paralyzed fold (7 patients) and medialization thyroplasty (4 patients). Pre-operatively, breathiness was worse (P < .05) in patients undergoing surgical intervention. CONCLUSIONS: Voice characteristics of pediatric UVFP include increased breathiness, hoarseness, straining, muscle tension, and soft loudness. One-fourth of patients underwent surgical intervention; breathiness was the predominant abnormal voice characteristic in the operative cohort. SIGNIFICANCE: The voice characteristics of pediatric patients with UVFP are described. EBM rating: C-4.

Published 27 March 2006 in Otolaryngol Head Neck Surg, 134(4): 618-21.
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