• Melissa Mortensen, Madeline Schaberg, and Peak Woo.
• Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, PO Box 800713, Charlottesville, VA 22903, USA. mm6nj@virginia.edu
• Arch. Otolaryngol. Head Neck Surg. 2010 Jan 1; 136 (1): 75-9.

ObjectiveVideolaryngostroboscopy (VLS) is a standard technique used for evaluating adult patients with dysphonia. However, while pediatric dysphonia affects 5% of children, children with dysphonia are traditionally examined with a flexible nasal endoscope. The purpose of this study was to determine whether VLS provides additional diagnostic yield in children.DesignA retrospective medical chart review was conducted from 2001 to 2006.SettingTertiary care center.PatientsPediatric patients aged 3 to 17 years (mean age, 11 years) who presented with prolonged dysphonia. All patients were previously examined by flexible laryngoscopy and treated with speech therapy for a presumed diagnosis of vocal cord nodules.InterventionsFlexible or rigid VLS was performed.Main Outcome MeasureThe diagnosis per patient established after VLS.ResultsEighty patients were included in the study: 50 underwent rigid VLS; 28 underwent flexible VLS; and 2 did not tolerate either procedure. A total of 132 diagnoses were made, including 68 benign mucosal diseases (41 nodules, 15 polyps, 8 cysts, and 4 sulci), 41 inflammatory disorders, 11 functional disorders, 6 congenital disorders, 4 traumatic injuries, and 2 neurologic disorders. Many patients received more than 1 intervention for their dysphonia, including antireflux medication and speech therapy, but 16 patients also underwent phonomicrosurgery.ConclusionsPatients with a history of prolonged dysphonia for whom treatment has failed should be referred for evaluation by VLS. Videolaryngostroboscopy elucidates subtle features of different disease processes; clarifies the differences between benign mucosal disorders that might require surgical intervention; and helps identify inflammatory processes that contribute to dysphonia. To our knowledge, these findings have not previously been reported in the pediatric population. Although most pediatric dysphonia can be attributed to benign nodules, our results show that inflammatory conditions and benign lesions other than nodules contribute to dysphonia and are often overlooked and undertreated.

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