Severity of Voice Handicap in Children Diagnosed with Elevated Lesions

Abstract

Objectives: Determine the impact of voice disability on children with dysphonia. The Pediatric Voice Handicap Index (PVHI) was used to assess impact on functional, physical, and emotional aspects of voice and oral communication. The degree of talkativeness and overall severity of dysphonia was also determined. Methods: Institutional Review Board approved study to examine severity of dysphonia in children evaluated at a voice clinic between 2007 and 2011. Setting: Tertiary specialized hospital. Medical records of 33 children (11 females, 22 males) diagnosed with an elevated laryngeal lesion by a pediatric laryngologist were reviewed for voice disability using the PVHI. The PVHI is a 23 statement instrument for perceived handicap in functional, physical, and emotional aspectsand includes a talkativeness rating scale (1-7 scale) and Visual-Analog Overall Severity Rating of Voice (100 mm line), all judged by the child’s parent/caregiver. Data were examined for young children (age 2-5), children (age 6-10), and adolescents (age 11-17). Results: There was no significant difference between age groups for overall PVHI (mean 29.3), but all groups had significantly higher functional disability (mean = 16) compared to physical (mean = 8.2) or emotional (5.1). Talkativeness averaged 5.1, and VAS averaged 40. Talkativeness was significantly greater for the child age group (5.6) compared to the young child and adolescent groups. Masses were more common in males. Conclusions: Children with elevated lesions have significant voice disability (PVHI = 29.3), greatest for functional aspects of voice, and present across all studied age groups. Mean severity was 47.1, and mean talkativeness was 5.1.