A child's voice is hoarse

In children, voice hoarseness occurs much more often than in adults. Consider the main causes of this symptom, types and forms, methods of treatment, prevention.

Voice is the sound waves produced by the passage of air through the vocal cleft of the larynx when the vocal cords are closed.

• The thinner and shorter the ligaments, the higher the voice.
• If the ligaments are even, the tone of voice is clear.
• Thickening and irregularities of the vocal cords disrupt the flow of air, creating interference in its path, which affects the pitch of the voice and manifests itself in hoarseness.

The appearance of wheezing, as a rule, is due to the structure of the upper respiratory tract of the baby. The mucosa of the larynx is very delicate and permeated with a large number of blood vessels. Any irritation or exposure to pathogens leads to the development of edema and dysphonia.

In some cases, there is a complete loss of voice, and even a direct threat to the life of the child. Therefore, the appearance of this symptom should be taken seriously. This is due to the fact that the unpleasant condition may be due to congenital diseases of the larynx (papillomatosis, cysts), requiring surgical intervention.

Epidemiology

The voice is a collection of different sounds produced by the oscillation of the elastic vocal folds. The sound of the voice is the oscillation of air particles that propagate as waves of rarefaction and densification. The main source of voice is the larynx and vocal cords.

According to medical statistics, voice disorders in a child have a prevalence of 1 to 49% and in adults from 2 to 45%. The main cause of dysphonia is a decrease in local immunity. An unpleasant symptom can develop against the background of diseases of the upper respiratory tract (acute respiratory viral viral infections, bacterial and infectious processes in the body and respiratory organs, as well as in stressful situations, congenital pathologies and injuries.

Voice disorder has a significant impact on the general and speech development of the child. The negative impact of this problem affects the formation of personality and the process of social adaptation of the baby. Several disciplines are involved in the study of voice disorders and hoarseness: pediatrics, psychology, speech therapy, endocrinology, neurology, physiology, phoniatrics.

Causes of the hoarseness of voice

Voice disorders in children are not an independent disease, but arise due to certain causes and factors. Some of them are harmless, others require careful diagnosis and treatment.

The main causes of hoarseness of voice in a child:

• Overstraining of the vocal cords - the laryngeal mucosa is very sensitive, so baby crying, loud screaming or singing causes microtrauma with rupture of small capillaries and swelling. This causes wheezing and hoarseness.
• ARVI, flu - one of the complications of colds is inflammation of the larynx. Laryngitis can be of viral and bacterial origin. In addition to sound disturbance, there is an increase in body temperature, runny nose, cough, sore throat. [1]
• Intoxication - inhalation of chlorine vapors and other chemicals causes spasms and swelling of the larynx, coughing. If the body is affected by ammonia, then there are pains behind the sternum, expectoration of sputum. Fluoride provokes convulsions, severe coughing, red eyes.
• Allergic reactions - contact with an allergen, insect bite, inhalation of irritating aromas causes allergy with soft tissue swelling. In particularly severe cases, Quincke's edema develops, which is manifested by laryngeal stenosis, breathing difficulties and suffocation. The stages of an allergic reaction change very quickly, so immediate emergency medical attention should be sought. [2]
• Foreign objects entering the larynx - this condition requires emergency diagnosis and treatment. Since the foreign body disrupts the passage of air into the lungs. Against this background, an attack-like cough develops, the face becomes pale or with a bluish tint. The child suffocates and loses consciousness. If the airways are not released in time, it is dangerous to die. [3]
• Burns - chemical and thermal damage to the mucous ligaments and windpipe causes severe swelling, tissue damage and subsequent scarring. This is dangerous not only because of the change in sound, but also because of the loss of the ability to speak. [4]
• Laryngeal trauma - hoarseness develops when there is a blow to the front or side of the neck. [5]
• Metabolic disorders - changes in the production of certain hormones affect the sound. Ligament swelling occurs due to fluid retention in the tissues. Hormone replacement therapy is used for treatment.
• Dehydration of the body - if you do not consume fluids for a long time, it causes dry mucous membranes and wheezing. [6]
• Stress, fright and excitement cause changes in the sound. After a while, the vocal apparatus recovers without assistance.
• Paresis and paralysis - the disorder occurs when the nerve endings of the vocal apparatus are damaged. The child feels numbness of the larynx and difficulty breathing.
• Tumor neoplasms - if they are located in the larynx, they can squeeze vessels and nerve endings. On this background there is periodic coughing, sore throat, hoarseness in the voice.
• Dysphonia is a qualitative disorder of the voice (changes in pitch, timbre, duration, strength). It develops due to overstraining of the vocal cords, respiratory diseases, congenital pathologies, psychological and behavioral factors. It is manifested by gradual voice fatigue and a feeling of tightness/feeling in the throat. May cause problems in expressing thoughts and may cause anxiety due to the child's limited communication. [7]

These are not all possible causes of hoarseness, so do not ignore the unpleasant symptom, as it can indicate serious pathological processes in the body.

Hoarseness of voice when teething

Emergence of teeth from the gums, is a painful process. In some children, the first teeth begin to erupt at 3-6 months, and in others at a year. The process of teething is individual, but almost all babies face such symptomatology:

• Redness and swelling of the gums.
• Elevated body temperature.
• Increased salivation.
• Itchy gums.
• Poor appetite.
• Digestive disorders.
• Sleep disturbance.
• Hoarseness of voice.

The appearance of the first teeth does not affect the state of the immune system. But the formation of a large amount of saliva leads to the fact that it loses its protective properties. This negatively affects the state of immunity and can accelerate the development of infectious diseases. Also against the background of changes in the sound can occur pain in the nose and ears, redness of the cheeks, runny nose.

To alleviate unpleasant symptoms, various painkillers, drugs to reduce body temperature are used. There is a special gel for teething. In this case, it is contraindicated to massage the gums with alcohol-containing preparations or rub tablets into the inflamed mucosa. As the child's condition improves, his voice, appetite, sleep are restored.

A child's voice is hoarse after a cold.

The most common cause of a child's hoarse voice is a cold. This term includes more than 200 respiratory viruses that are transmitted by airborne droplets. The painful condition is manifested by such symptoms:

• Elevated body temperature.
• Runny nose.
• Increased lacrimation and tearing in the eyes.
• Headaches.
• Cough
• Voice change.

Often a cold is complicated by damage to the vocal apparatus. Because of this, the patient's voice becomes hoarse, hoarse. But as the patient recovers, the sound is restored.

There are a few simple methods that can help you quickly restore a voice that has become hoarse after a cold:

1. Silence - the ligaments need rest and warmth. Wrap a scarf around your baby's throat, have your baby whisper or play silent games.
2. Drink plenty of water. The best remedy to restore the sound is warm milk with honey, warm tea, herbal decoctions. Such drinks can be consumed throughout the day and necessarily before going to bed.
3. Gargles - pharmacy preparations or decoctions/infusions of herbs can be used for this purpose. Chamomile flowers have antiseptic properties, and eucalyptus leaves have antimicrobial properties. Take 1 tbsp. Dry raw materials, mix thoroughly and pour 300 ml of water. Boil the decoction over low heat for 1-2 minutes. After cooling, strain and give the child to gargle the throat. Procedures are carried out every 2 hours until the complete elimination of disorders.

4. Inhalation - herbal remedies are suitable for this purpose. You can prepare a decoction based on chamomile, eucalyptus, calendula, mother and stepmother. Dilute a tablespoon of herbs in a liter of boiling water, cover your head with a towel and breathe.

If the main symptoms of a cold have passed, and the hoarseness persists for a long period of time, the child should be shown to a pediatrician.

A hoarse voice with stomatitis in a child

Stomatitis is an inflammation of the mucous membrane of the oral cavity. Most often it appears on the inner surface of the cheeks, lips and palate, under the tongue.

Stomatitis develops due to opportunistic flora of the oral mucosa. With the action of certain factors, the body's immune defense is reduced, and viruses / bacteria are activated. Also possible causes of the disease include:

• Violation of the integrity of the oral mucosa.
• Unbalanced nutrition.
• Violation of hygiene - eating unwashed vegetables, fruits, licking dirty fingers, improper dental care.
• Taking medications that reduce salivation.
• Chronic diseases.
• Disorders of the gastrointestinal tract.
• Endocrine pathologies.
• Anemia.

Depending on the nature of the affecting action, several types of stomatitis are distinguished: bacterial, fungal, viral, radiation, chemical. But regardless of the cause of occurrence, stomatitis is manifested by an acute intoxication syndrome, which includes:

• Redness and swelling of the mucosa.
• Formation of rounded ulcers (the wound is covered with a white film, and there is redness around it).
• Pain and burning on contact with the affected mucosa.

Against the background of the disease, body temperature rises, submandibular lymph nodes increase. If the child's voice is hoarse with stomatitis, it indicates the spread of the pathological process to the mucosa of the larynx.

For treatment prescribe rinses with disinfectants, taking antimicrobial drugs, refusal of aggressive food (hard, acidic, spicy, hot, cold), proper oral hygiene. Therapy takes 5-10 days. The voice is restored as it recovers.

After a sore throat, the baby's voice is hoarse

One of the most common otolaryngologic diseases in children is acute tonsillitis. Angina is an infectious-inflammatory process with lesions of the palatine tonsils. Its main etiologic agent is beta-hemolytic streptococcus, less often there are pneumococci and staphylococci. There is also a monocytic sore throat caused by cytomegalovirus and agranulocytic, which develops with pathologies of the hematopoietic system.

The basic symptomatology of the disease:

• High body temperature.
• General weakness and malaise.
• Sore throat that gets worse when swallowing.
• Enlargement of submandibular and cervical lymph nodes.

Such a symptom as voice change (hoarseness, wheezing) deserves special attention. It develops due to inflammation and swelling of the larynx and tonsils.

To diagnose tonsillitis, the patient is examined and a set of laboratory tests (smear microscopy, bacteriological seeding of secretions from the surface of the tonsils, smear for hemolytic streptococcus, PCR). Treatment consists of strict bed rest, gentle diet, abundant drinking. Patients are prescribed gargles with antiseptic and analgesic agents.

To restore the voice as soon as possible, it is necessary to provide rest to the vocal cords, drink plenty of warm liquids, avoid irritating mucous membranes. To increase blood circulation and accelerate the recovery process will help dry heat (warm scarf on the throat or baths with mustard in the absence of fever). At night, the child can be given a glass of warm milk, dissolving in it a piece of butter and honey.

If voice problems and other painful symptoms persist for an extended period of time, it may indicate the development of complications of angina (rheumatism, glomerulonephritis, arthritis, paratonsillar abscess and others) that require serious medical attention.

Risk factors

Since a child's hoarseness of voice can occur due to a variety of causes, the risk factors vary from case to case.

The main factors contributing to sound change include:

• Voice strain.
• Body hypothermia.
• A long silence.
• Colds and viral diseases of the upper respiratory tract.
• Psychotraumatic factors (neuroses, severe fright, stress, depression).
• Hormonal disturbances.
• Craniocerebral injuries.
• Neurological diseases.
• Cerebral circulation disorder.
• The effects of medications.
• Allergic Reactions.
• New growths (polyps, nodules of the vocal cords).
• Diseases of the gastrointestinal tract.

The above factors provoke a decrease in local immunity and irritation of the mucosa of the vocal cords.

Pathogenesis

The mechanism of the development of hoarseness is directly related to the structure of the vocal apparatus. The following organs and structures are involved in the process of vocalization:

• Lungs
• Bronchi
• Trachea
• Throat
• Nasal cavity
• Nasopharynx and larynx.

Inside the larynx are the vocal cords. They are two folds of mucous membrane covering muscles and cartilage. Normally, they open and close smoothly, so that sounds are produced when air passes through.

When exposed to pathogens, the mucosa is affected. Infection causes local swelling and inflammatory reaction. This in turn leads to difficult breathing and loss of voice. A similar pathogenesis has hoarseness due to intense tension of the vocal cords. But unlike infectious processes, in this case, the sound is restored when the vocal cords are at rest.

Allergic reactions in the larynx provoke swelling of the throat, which causes not only voice disorders, but also life-threatening choking. In some cases, the pathogenesis is associated with weakness of the vocal cords and neoplasms in the respiratory system.

Symptoms of the hoarseness of voice

There are many different factors and causes that cause sound disturbances. If the unpleasant condition is caused by laryngitis, its first signs are manifested by hoarseness, barking cough and other symptoms:

• Shortness of breath.
• Painful sensations when swallowing.
• Dry, barking cough.
• A swollen and red throat.
• Elevated body temperature.
• Laryngeal muscle spasms.
• A sensation of dryness and a sensation of dryness in the mouth.

Many other infectious diseases have similar signs.

Also distinguish a number of symptoms that occur against the background of hoarseness and require emergency medical care:

• A low, deep voice.
• Dry, barking cough.
• Difficult breathing with whistling and intercostal retraction.
• Expressed respiratory movements of the chest.
• Difficulty swallowing.
• Increased salivation.

Children's larynx is very narrow, so in case of severe swelling of the sublaryngeal tissues (observed in allergic reactions, infections, viruses and bacteria) its lumen is completely blocked, causing asphyxia.

Stages

Hoarseness of voice in a child is not an independent disease, but acts as one of the symptoms of various pathological processes in the body. Therefore, the stages of dysphonia depend on its underlying cause.

For example, if the change in sound is due to laryngitis, the disorder has these stages:

• Acute - sharp pain in the throat, burning, painful swallowing, dry (barking cough). Against this background, there are changes in the voice, it sits down, becomes hoarse. The vocal cords are swollen and hyperemic.

• Chronic - characterized by slow progression. The patient has problems with the throat and vocal cords for a long period of time. There is a constant desire to cough. The voice is hoarse with pronounced wheezing.

In this case, the methods of diagnosis and treatment depend on the stage of the disease. In this case, the acute form is better succumbed to therapy than the chronic form. The latter may be complicated by frequent relapses.

Forms

Based on the etiopathogenetic mechanism, voice disorders, to which the ossification in children refers, can be organic and functional.

1. Functional disorders - they are not associated with anatomical changes in the vocal apparatus. Most often their appearance is caused by neurotic disorders, which in turn are divided into:
   1. Central - due to the action of a strong stimulus in the cerebral cortex there is a focus of inhibition, which disrupts the regulation of the process of voice formation.
   2. Peripheral - the disorder is caused by a decrease/increase in the muscle tone of the vocal cords, a violation of the coordination between breathing and the function of the resonatory cavities.

Functional voice disorders are characterized by disorders of secretory functions with the sensation of a foreign body in the larynx, sharply increased motor function of the larynx, possible discoordination between speech breathing, articulation and vocalization. In some cases, neurological symptoms are observed: sleep disturbances, high tendon reflexes.

2. To organic types of dysphonia can be attributed anatomical anomalies of the structure of the vocal cords, inflammatory, infectious and other pathological processes in the body.

Complications and consequences

Lack of timely diagnosis and proper treatment of voice hoarseness in a child, is dangerous for the development of very serious complications. The consequences of an unpleasant symptom depend on the cause of its origin. If the violation of the sound is provoked by an acute form of laryngitis, it threatens such complications as:

• Respiratory abnormalities due to narrowing of the walls of the larynx.
• Complete loss of voice.
• Vocal cord neoplasms (granulomas, polyps).
• Tumor lesions of the larynx.

Another common complication of inflammatory processes in the larynx, occurring in 90% of children, is stenosis or false croup. There is also a risk of developing purulent forms of laryngitis, which in turn can lead to inflammation in the chest cavity, lung abscesses, purulent inflammation of neck tissues, and infection of the bloodstream.

Diagnostics of the hoarseness of voice

Diagnosis of the problem of voice disturbance and hoarseness in pediatric patients is carried out by a pediatrician. To determine the cause of the disorder, a set of various tests is carried out:

• Gathering a history and analyzing the patient's complaints.
• General examination of the child (palpation of lymph nodes, presence of sore throat).
• Visual inspection of the larynx with an endoscope (reveals narrowing of the laryngeal lumen, the presence of edema and hyperemia, purulent or mucous plaque on the mucosa).
• Laboratory tests (general and biochemical blood tests, urinalysis, mucosal swabbing).
• Instrumental studies.

If the painful condition is not caused by viral or infectious processes in the body, then further diagnosis of the causes of sound disturbance is carried out by an otolaryngologist, phoniatrist, neurologist, speech therapist.

Based on the tests performed, the final diagnosis is made, and treatment tactics are determined. If the hoarseness is caused by respiratory pathologies or narrowing of the larynx, there is a risk of croup, so the child is hospitalized. Inpatient treatment is indicated for hoarseness due to allergic reactions, CNS diseases.

Analyses

Laboratory diagnosis of causes of dysphonia in children includes such tests:

1. General and biochemical blood tests.

Blood acts as a multifunctional fluid, so its analysis allows you to identify various abnormalities in the functioning of the body. Most often patients are prescribed a general blood test, which within a short period of time reveals bacterial, viral and other pathogenic microorganisms.

Particular attention is paid to the level of leukocytes, which act as indicators of the immune system. If their level is elevated, it means that the immune defenses are activated and there is a pathogen in the body.

Another important indicator is the erythrocyte sedimentation rate. When inflammation occurs, a large amount of protein is formed, which leads to an increased sedimentation rate.

2. Urinalysis

Urine is an important product of human activity. It removes toxic substances, decomposition products, hormones, salts and other compounds from the body. The analysis takes into account the physical, chemical and organoleptic properties of this biological fluid. The laboratory technician emphasizes the indicators of color, density, odor, transparency and acidity. A macroscopic examination of the secreted fluid is also performed.

3. Swabbing of the laryngeal mucosa to determine the pathogen and sputum analysis.

Sputum is an abnormal secretion from the respiratory tract (lungs, trachea, bronchi). Sputum analysis is a laboratory examination and evaluation of the general properties and microscopic characteristics of the secretion.

Smear from the mucosa, as well as sputum analysis, allow you to diagnose pathological processes in the lungs and respiratory tract. Assess the nature of the pathological process in the respiratory organs. Conduct dynamic monitoring of the state of the respiratory tract to assess the effectiveness of therapy.

Based on the results of the tests, the doctor makes a plan for further diagnosis or prescribes therapeutic measures.

Instrumental diagnostics

Another component of the examination of the body to determine the causes of hoarseness in the voice is instrumental methods. They include such diagnostic procedures:

• Stroboscopy - assessing the function of the vocal cords.
• Laryngoscopy - performed to detect anatomical or inflammatory changes in the vocal apparatus.
• Radiography and MSCT of the larynx - reveals tumor lesions of the larynx.
• Electromyography - assessment of laryngeal muscle function.
• Electroglottography - assessment of changes in the vocal apparatus in dynamics.

In addition to the above examinations, laryngeal tomography, densitometry of the bones of the cervical spine, and acoustic voice examination are performed.

Also children are shown speech therapy examination, which includes assessment of voice features, physiological and phonation breathing, character of vocalization.

Depending on the results of the diagnosis, further consultation of the child may be engaged in a surgeon, endocrinologist, phoniatrist and other specialists.

Differential diagnosis

There are many causes that cause hoarseness in the voice in a child. To determine the true cause of the pathological condition, differential diagnosis is performed.

Differentiation is made with pathologies such as:

• Viral and bacterial diseases.
• Laryngitis.
• Diphtheria of the larynx.
• Laryngeal obstruction.
• Dysphonia.
• Pharyngeal abscess.
• Intoxication of the body.
• Allergic Reactions.
• Acute epiglottitis (inflammation of the epiglottis and surrounding tissues of the larynx and pharynx).
• Vocal cord strain.
• Foreign objects entering the larynx.
• Burns and herbs of the larynx.
• Metabolic disorders.
• Pareses and paralyses.
• Stress, extreme fright and excitement.

When making a final diagnosis, the results of differential, instrumental and laboratory diagnostics are taken into account.

Treatment of the hoarseness of voice

An essential part of the treatment is silence, i.e. Rest for the vocal cords. When a person is silent, the vocal chord is open and the ligaments are as far apart as possible. When talking, the ligaments come closer together and rub against each other, which leads to micro-damage. Therefore, if the ligaments are inflamed, talking will only aggravate their condition and cause additional painful symptoms.

Read more about treatment of voice hoarseness in children in these publications:

• Methods for treating hoarseness of voice in a child
• Inhalation for hoarseness of voice in a child
• Syrups for hoarseness of voice in a child

Prevention

There are several recommendations that keep the respiratory system healthy and act as an excellent prevention of voice hoarseness:

• Avoid yelling, as it is a major cause of a disrupted, hoarse voice.
• Control the humidity level in the room.
• Annual flu vaccination.
• Avoid contact with people with colds and other illnesses that are airborne.
• Wash your hands more often.
• Timely treatment of inflammatory lesions of the respiratory system.
• Use of respirators when exposed to allergens or working with toxic substances.
• Limit your child's exposure to smoking areas.
• Limit the consumption of spicy and spicy foods, as they cause increased secretion of hydrochloric acid in the stomach and its entry into the esophagus and pharynx.

In addition to the above tips, it is not recommended to sleep without a pillow, as this leads to the back throw of acidic contents from the stomach to the throat, which in addition to disturbing the sound can cause heartburn.

Forecast

Hoarseness of voice in a child in most cases has a favorable prognosis. The earlier the diagnosis was made, the causes of the painful condition were identified and treatment was prescribed, the lower the risk of developing various consequences and complications. At the same time, it should be taken into account that voice disorders in pediatric patients negatively affect their general and speech development. The violation affects the formation of personality and the process of social adaptation.