Hoarseness of the child's voice: why and what to do?

The hoarse voice of a child is an alarming sign, which can indicate both a temporary, transient physiological state, and a serious illness.

In medical terminology, a condition called "hoarse voice" is defined as one of the types of dysphonia. Dysphonia, in turn, is a qualitative change when the child speaks, the baby sounds, but the timbre, loudness, and the sound spectrum of the voice change. Hoarseness is not a disease, but a symptom, therefore, the sooner parents pay attention to it, the faster and easier it will be to eliminate the causes. This is especially important when the wheezing voice of a child in the age of 2-3 years.

Epidemiology

The epidemiology of diseases that provoke the symptom of "hoarse voice in a child", directly depends on a specific diagnosis. More often hoarseness is caused by a laryngitis, its various forms. The inflammatory process develops in the child's larynx, the background of inflammation can be primary infectious, cold diseases. Less commonly, laryngitis is due to voice overload, a physical factor. In general, in pediatric practice, it is believed that almost all the inflammation of the vocal chord zone is laryngitis, as a specific type of acute respiratory viral infections (ARVI). The most dangerous form of laryngitis, when the mucous tissue of the larynx swells and narrows, except that parents notice - hoarse voice in the child, the baby breathes with difficulty, swallows food, and sometimes liquid. Such a stenosing form of inflammation requires immediate medical attention.

Epidemiology of the causes with which dysphonia is associated, hoarseness:

1. The carrier of the infection, as a rule, is already a sick person. It is no accident that ARVIs are so common in children's institutions, one kid can infect with a dozen others, especially if the infection is in a catarrhal form (cattle - catarrhal-respiratory syndrome).
2. The causative agent of infectious inflammation is allocated from 7 to 10 days, possibly recurrence and re-infection, in which the isolation of the infectious agent (virus) is reduced to 3-4 days.
3. If the carrier of infection suffers from acute respiratory viral infection without catarrhal symptoms, it is relatively epidemiologically safe for others.
4. Transmission of the virus is carried out by standard - airborne method.
5. Children aged one to five years are most vulnerable. Breastfed babies have specific immune protection under the condition of breastfeeding. Children taking artificial food are at risk of infection. Breasts up to 4-5 months suffer from acute respiratory viral infections very rarely.
6. The prevalence of the symptom "hoarse voice in a child" is due to seasonality. Most children get sick in the cold season, however, outbreaks of mass infection can be sporadic (sudden, without obvious reasons).
7. The cases of parainfluenza diagnosis in autumn are associated with type 1 and 2 viruses, the "spring" ARVI is characterized by the detection of type 3 virus.
8. Dysphonia, hoarseness of voice, not associated with the etiology of viral nature, are statistically "tied" to pre-school and school institutions. Physical overstrain of ligaments in "home" children is less common than in preschool children attending kindergartens.
9. Among the causes of hoarseness symptoms, acute laryngitis is leading, followed by laryngotracheitis with signs of stenosis, in third place - functional ligament congestion and mutation in the pubertal period (boys), the list is completed - chronic laryngitis and congenital abnormalities of the vocal apparatus, including papillomatosis, paresis, cicatricial stenosis.
10. Virtually all violations of the voice process, throat diseases, are treated by a doctor of a narrow profile - an otorhinolaryngologist.

[1], [2], [3], [4],

Causes of the hoarseness of the child's voice

In order to find out why the child has a hoarse voice, it is necessary to consult a doctor, as a rule, these questions are initially dealt with by a pediatrician who can refer the baby to an ENT doctor (otorhinolaryngologist).

In otorhinolaryngology, there is a classification of dysphonia according to etiological signs, by types:

• Functional factors. Overexertion of the vocal apparatus, when the child speaks loudly and loudly, screams
• Diseases of viral, inflammatory etiology
• Psychogenic causes - stress, fear, severe shock
• Injuries of the larynx
• Age, physiological weakness of the vocal cords
• Diseases associated with impaired endocrine function
• Congenital pathologies

Why does a child with a hoarse voice find out only a specialist, a doctor, like no other, knows that the causes of dysphonia can be due to age, situational cause or disease. Let's consider the reasons more in detail, we will try to answer a question - why the child has hoarse voice.

1. A hoarse voice in very young children, newborns. Congenital, functional and acquired abnormalities of the vocal apparatus:
   • Syndrome "cat's scream", congenital, chromosome disorder, which, fortunately, is rare. Diagnosed only in the complex - the classic signs of the disease and genetic research
   • Syndromes associated with hereditary chromosomal disorders - Down syndrome, Williams, Pfeiffer. The hoarse voice of a child is just one of the symptoms, with genetic distortions there are more characteristic signs of the mentioned syndromes
   • Acquired meningitis or encephalitis, when the hoarseness of the baby's voice is caused both by the disease and the overstrain of the vocal cords from crying, crying
   • Functional overstrain of the vocal cords of the baby, when he screams because he is hungry, he is uncomfortable, cold, damp
   • Congenital atony or one-sided paralysis of the vocal apparatus, such conditions tend to spontaneously heal, most likely associated with the age development of all systems and organs of the baby
   • GERD, physiological gastroesophageal reflux in children, accompanied by a hoarse voice, can be explained by the abnormal structure and development of larynx - laryngomalacia
2. In older children, the hoarse timbre of the voice can be associated with two categories of causes: functional and organic. Of course, functional states are faster and almost do not require treatment, while diseases associated with viruses, inflammations need therapy, including medication.
3. Why does the child have a hoarse voice? Perhaps because it is a long time and is constantly in a foggy atmosphere. Corrosive smoke adversely affects the mucous tissue of the larynx, the respiratory apparatus. All this leads to puffiness, promotes the appearance of nodes on the vocal cords and provokes hoarseness
4. Psycho-emotional reasons. The child is not just afraid, but shocked, he is stressed. If there is a spasm of the larynx muscular tissue, a temporary hoarseness of the voice is almost inevitable
5. Excessive tension of the voice, which is possible if the child is engaged in vocals, often and for a long time performs singing assignments. This state is typical for many vocalists
6. A strong cry, a prolonged crying, in which the voice apparatus is overstrained, the ligaments touch and injure, damage each other
7. Diseases of viral or inflammatory etiology, all types of SARS. The folds of the vocal apparatus are located between the cartilaginous tissue of the larynx. Any inflammation of the airways inevitably provokes a pathological process in the vocal cords. It can be a tracheitis, a laryngitis, a pharyngitis, and also a tonsillitis, a bronchitis, a flu and other illnesses which we will consider more low.

Risk factors

A voice for a child is not just a way of communicating, but an instrument for expressing one's emotions. The hoarse voice of the child - this symptom means that the baby's voice is at risk. Risk factors can be different, before they list, it should be understood how the child has ligaments, the larynx and how they develop.

The larynx at an early age is quite specific - it is located slightly higher than in adults. This is especially true for infants who, with the help of the larynx, breathe and swallow at the same time. In turn, the child's throat initially has the shape of a cone, which gradually acquires a cylindrical shape with age. Just like the larynx, the pharynx, the ligament of the child is specific. In newborns, they are very small - up to 8 millimeters, ligaments grow together with the body and reach puberty age 17-22 millimeters. All these factors affect the phonetic characteristics of the child's voice, its timbre, volume and other parameters. Any overexertion, bacterial, viral infection can affect the voice device and cause a symptom that is defined as "hoarse voice in the child".

Risk factors that should alert the attentive parents:

• The voice changes its timbre, becomes rough, low
• Cough acquires a "barking" nature
• The child's breathing becomes heavy, a sound like whistling is heard
• When breathing, the chest clearly rises and falls
• The child is difficult to swallow, he loses his appetite
• When breathing in the child, salivation increases

All of the above signs can be transient, however, one should consider the narrowness of the larynx of the baby, the physiological characteristics of the vocal apparatus and the risk that the swollen larynx can completely block the possibility of breathing. Even chronic laryngitis, which is often the root cause of hoarseness, is also considered a disease that requires medical advice, examination and adequate treatment.

Especially dangerous risk factors for constriction (stenosis) of the larynx, which can develop with laryngitis, accompanied by fever. The mucous tissue of the larynx becomes inflamed, swells, breathing becomes heavy, intermittent. A severe form of stenosis is very dangerous, which can lead to the stopping of breathing. In the category of risk first of all, newborn babies do not have a respiratory and voice apparatus, the tissue of the folds is very loose and very sensitive to any negative process. If the voice is hoarse in a child under the age of one year, parents should immediately contact the pediatrician who is treating the doctor.

[5], [6], [7], [8]

Pathogenesis

Pathogenesis rather refers to the description of the underlying causes of the underlying disease, which provokes a symptom - hoarse voice in the child. Most often hoarseness as a sign indicates a respiratory viral infection or a laryngitis. Statistics show that every year, children have a growing number of different types of voice disorders. This is especially typical for schoolchildren, which is conditioned by communication processes (the child speaks more and more often to peers, answers at lessons, emotionally reacts to negative or positive phenomena of school life).

In general, violations of the voice function, including hoarseness, can be divided into the following groups:

• Changes in the voice, saturation and volume of the voice
• Qualitative changes - hoarseness (dysphonia)
• Changes in the resonance of the voice (the child speaks as if "in the nose" - hyper or hyponasality)

Pathogenesis and etiology of hoarseness (dysphonia), as a rule, is associated with such causes:

• Psychogenic factors
• Endocrine disorders
• Traumatic factors
• Infections

The cases when doctors detect so-called "singing" knots in children, in the middle zone of ligaments - polyps, and the symptom "hoarse voice in a child" may have a root cause associated with GERD (gastroesophageal reflux) - the so-called reflux-laryngitis. The nodes that cause hoarseness are peculiar to emotional children, who quickly and violently react to events in a scream format. Such a child can be labile in the psychoemotional sphere, sometimes aggressive, exciting. The nodal factor in young children often self-destruct with the onset of puberty, but this does not mean that dysphonia should not be treated. It requires both a drug correction and a consultation of a child neurologist, a psychologist.

One of the rare causes, which is worth mentioning, is laryngeal papillomatosis of recurrent nature. If parents notice that hoarse voice in a young child, and hoarseness is progressing, you need not hesitate, but turn to a pediatrician, an ENT doctor. Progressive dynamics of the symptom indicates a developing stenosis of the larynx, especially it is dangerous in cases when the child begins to "warm up" the throat. This increases swelling and accelerates the growth of benign small tumors. Sometimes doctors have to resort to surgical intervention to remove papillomas, as a result - the symptom of "hoarse voice in the child" does not disappear, because the operation is scars, and scars are a local stenosis of the vocal cords.

Also, hoarseness of the voice can cause tracheitis, as its acute, or chronic form, especially it is characteristic of laryngotracheitis. Pathogenetically hoarseness in tracheitis is explained by the expansion of the vessels and swelling of the mucous tissue, which can not but affect the voice function.

The pathogenesis of diseases that provoke a sign of hoarseness is directly related to the underlying cause, which in turn can be both functional and pathological. "Lead" in this sense is still viral laryngitis and slightly behind laryngitis ORVI, ARI, then there is epiglottitis, provoked by the virus type B (Haemophilus influenza), close the series - psychogenic and physiological factors. Other diseases, fortunately are diagnosed much less often.

[9]

Symptoms of the hoarseness of the child's voice

Signs that the baby is unhealthy will be noticed by any attentive parent. Symptoms of a child's hoarse voice are quite characteristic:

• The child can complain of a feeling of persecution, irritation in the throat.
• The voice weakens at first, becomes quieter.
• The child begins to cough.
• There may be difficulty in swallowing food.
• The kid complains of a sore throat.
• Often the symptom of "hoarse voice in a child" is accompanied by an increase in body temperature.
• A baby can get a headache, he becomes listless, apathetic.
• Visually, parents may notice redness in the throat.

Symptom - hoarse voice in the child, in fact, is one of the first signs of the disease, which is most often laryngitis. Clinical manifestations of laryngitis are characterized by the fact that the baby becomes sluggish, quickly gets tired, loses activity. Quite often there is a transient increase in body temperature. If the parents turn to the doctor and the child is examined according to all the rules, the blood test clearly shows the inflammatory process: - increased level of leukocytes and acceleration of the ESR.

Symptoms of hoarse voice in a child depend on the localization of the inflammatory process. Most often affects the zone above the larynx, slightly less often - the posterior zone of the throat, these inflammations affect the process of swallowing food, provoke pain when eating. In addition to pain and the "hoarse voice" symptom, the child can complain of heaviness in the chest, shortness of breath, restless sleep. Problems with breathing are caused by swelling of the mucous membrane of the throat, constriction and spasm of plica vocalis (voice folds). The acute form of laryngitis can be accompanied by dryness in the oral cavity, hoarseness, frequent coughing and even an abscess in the area of the glottis, this condition requires immediate hospitalization of the child. For chronic laryngitis, there is a long period of hoarseness, general fatigue, malaise.

Symptoms of hoarse voice in a child are directly caused by the clinic of the underlying disease, if laryngitis is diagnosed, the symptoms can be conditionally divided into the following categories:

• Chronic laryngitis, catarrhal form - constant irritation, perspiration in the throat, dysphonia (a timbre has changed, a hoarse voice). The child may also have signs of a slow inflammatory process - subfebrile temperature, drowsiness, headache. The painful condition lasts no more than 7-10 days, then the kid goes on the amendment under condition of adequate treatment and observance of all the doctor's advice.
• Acute laryngitis as a consequence of the started process of acute respiratory viral infection: body temperature jumps, periodic cough without phlegm, discomfort in the throat, sore sensations, difficulty in swallowing food, weakened intermittent breathing. Treatment is longer, often with the use of physiotherapy procedures. This form of the disease lasts from 7 to 15 or more days, including the recovery period.
• The atrophic form of laryngitis in children is less common, the symptoms are a permanent unproductive cough, an enduring hoarse voice. This kind of laryngitis is provoked mainly by functional factors - irritation of the vocal cords, their overload (intense vocal, voice, scream). It is treated for a long time, persistently with the observance of a gentle voice regime, which for children is considered a rather difficult task given their age-related motor and psycho-emotional activity.

[10]

First signs

The first signs of malaise are what parents call "hoarse voice in a child". As a rule, children are active and do not immediately complain of poor health, but symptoms are manifested in speech. Before the throat begins to sate, there is a sensation of pain and pain when you swallow food, the child's voice loses the usual timbre and the volume becomes lower, with hoarseness. In medicine, changes in voice characteristics are usually called dysphonia. The total loss of the ability to speak is aphonia. In addition to that hoarse voice, the child begins a slight cough, turning into a debilitating dry cough. Many children complain of a headache, quickly get tired and become lethargic. The most disturbing are the first signs in very young children. At them inflammatory processes proceed actively, often in the acute form that is fraught with puffiness of a mucous larynx and problems with breath. Strong, swift edema can provoke a violation of inspiration, the respiratory process becomes intermittent, noisy. Kid restless sleeps, often screaming, which further exacerbates the symptoms of the disease. The fact that in pediatrics is called a false cereal, is considered quite dangerous, a crisis state and requires the hospitalization of a small patient.

The first signs of major, provoking hoarseness, diseases:

1. Laryngitis (inflammatory process of the larynx), laryngotracheitis:

• False groats (from croup - croaking) - an acute process that provokes ARVI, ARD. Symptoms - barking, characteristic, hoarse cough, specific wheezing at inspiration, fever, hoarseness, general uncomfortable state of health, malaise. False croup should be differentiated from a more serious, health-threatening disease - diphtheria, true croup. Therefore, the first signs of illness should induce parents to show the child to the doctor and take all measures to treat the disease.
• Chronic laryngitis on the background of prolonged course of acute respiratory viral infection (parainfluenza viruses). Symptoms - pershit throat, loss of appetite, poorly swallowed food, the child loses activity, talks with characteristic hoarseness, often coughs, as if "clears" the throat. Subsequently, dry cough becomes productive and sputum is released.

1. Pharyngitis (inflammatory process in the pharyngeal mucosa). The first signs depend on the types of pharyngitis:

• Acute, chronic form and their types:
  • viral,
  • allergic,
  • fungal,
  • bacterial,
  • pharyngitis associated with a throat injury,
  • functional,
  • atrophic,
  • catarrhal,
  • granular,
  • mixed kind.
• The most common mixed form, which is characterized by the following first clinical signs - pain in the throat, transient hoarseness, irritation, perspiration, frequent cough without phlegm, transient increase in body temperature, lymph nodes in the neck can be increased.

In addition, that wheezing voice, the child may have pain in the arms and legs (myalgia), there is all the symptomatology, characteristic of acute viral inflammation, including rhinitis, fever up to 38-39 degrees, vomiting, rashes. Chronic forms of the underlying disease are less pronounced, but also inevitably expressed in hoarseness of voice and pain in the throat or larynx.

[11], [12]

The hoarse voice of a one-year-old child

Ohrip voice, in a one-year-old child, this symptom can be considered a clear clinical manifestation of the disease. In children up to 2.5-3 years, the tissue of the larynx is very vulnerable, it is loose, unformed. In addition, the larynx is not yet anatomically developed and rather narrow. Any inflammatory process provokes compaction and swelling of the mucous membrane and causes hoarseness, dyspnea, until the total air access is blocked. The stenosing form of laryngitis, false croup for babies is a serious test. If the wheezing voice of a one-year-old child, parents need to urgently call a pediatrician and take all measures to treat the baby. Who is at risk of acute obstructive laryngitis?

• Babies from 6 months to 2-3 years.
• Children who have a history of having a risk of allergic diseases (parents are sick, one of the parents).
• Children with insufficient or excessive body news.
• Babies with thymomegaly (an increase in the thymus, thymus gland).
• Children suffering from intestinal dysbiosis (dysbacteriosis).

What symptoms, other than the sign "hoarse voice in a child," may indicate developing laryngitis? Symptoms can be varied and depend on the type, type of virus:

• ARVI is provoked by paraviruses and is accompanied by a transient rise in body temperature.
• The catarrhal form of laryngitis can be manifested in hoarseness, sore throat, but without fever.
• One of the clinical manifestations may be a cough, in the early days it is dry, frequent, then becomes deeper and is accompanied by sputum discharge.
• Cough is characteristic of coughing during sleep, often at night.
• The baby's breathing always changes, it can be with characteristic wheezing sounds, the breath is longer than the exhalation.
• One-year-old baby is anxious, loses appetite.
• Signs of false cereal can be - noisy wheezing, coughing, specific lifting and lowering of the chest with inspiration and exhalation, cyanotic skin tone in the nasolabial triangle.

If the voice is hoarse in a one-year-old child, and besides the hoarseness the above signs are observed, the baby needs to be shown to the doctor and treated. The acute form of the disease, the troubling symptomatology of difficulty breathing, requires immediate hospitalization. With timely help, the symptom itself "hoarse voice in a child" is not threatening, the baby's condition improves fairly quickly.

To remove the anxiety of parents, it should be mentioned that hoarseness of a child up to a year can be caused by a completely "peaceful" reason - frequent screaming, crying. And, the kid screams not because he is sick, but because of a specific psycho-emotional status. "Screamers" are usually very active, brightly react to any event, new people, unfamiliar circumstances. Impressiveness, lability of the nervous system and emotionality can play a peculiar negative role in the formation of the child's voice, which has not yet formed a larynx or a ligament. However, frightened functional hoarseness is not worth it. Infants grow fast enough, the voice apparatus develops, and hoarseness passes completely.

The baby has a fever and a hoarse voice

When a child has a fever and a hoarse voice, many parents think that these are signs of a common cold, but such symptoms are not standard for ARVI or ARI. More often it is hoarseness - this is the first clinical manifestation of laryngitis, which in turn has different etiological bases and is divided into species.

Ohrip voice, the child's body temperature rises, what should I do?

Of course, call a doctor. For an experienced pediatrician, sibilant, shortness of breath, hyperthermia, a characteristic sound of the voice (dysphonia) is information about a clinic of the inflammatory process in the larynx. Laryngitis can take place in an acute form, but it can also be chronic, protracted. For the baby, the second option is most anxious, because the chronic process interferes with normal breathing, drains the entire body.

What could be the reason that the child has a fever and a hoarse voice?

• Viral infection (parainfluenza) - seasonal, out-of-season ARVIs cause many troubles, both to the baby and to the parents. ARVI is most often affected by children with insufficiently active immunity, those who have an angina periodically diagnosed, in short, children, whose pediatricians are categorized as BCD (often ill children).
• Allergy. If the history of the child indicates the allergic status of the parents, laryngitis may be due to allergens. In their role most often come from smells from household chemicals, hairs, animal hair, feathers, down pillows, blankets, toys, dust or some component of nutrition. The raised temperature at an allergy happens seldom enough, nevertheless, an acute attack can be accompanied by a jump in temperature.
• Immaturity of the mucous tissue of the larynx, ligaments. Children have anatomical specificity in the structure of the larynx - it is up to a certain age narrow, mucous loose, prone to puffiness. Such a cause is often the "base" for relapsing tonsillitis, laryngitis. Frequent coughing, constant irritation of the larynx often causes subfebrile temperature.
• Psychoemotional stress. The nervous system of the baby is quite labile, unstable, an event that the adult reacts to calmly, the child responds with frustration, crying. Both the overstrain of the vocal cords and the nervous spasm of the larynx muscular tissue can provoke hoarseness of the voice and even a rise in body temperature.

Signs of developing laryngitis, in which the child has a fever and a hoarse voice:

• The creeping timbre of the voice does not pass within 2-3 days.
• The voice can "tremble", break down.
• Body temperature does not usually exceed 37-37.5 degrees, but temperature jumps can be sudden, up to 39 degrees.
• Often on the third day there is a characteristic cough, and then a kind of barking cough. Coughing occurs on inhalation, exhalation is accompanied by a wheezing sound.
• The breath of a child is atypical, it is difficult for him to do both inhaling and exhaling, the thorax visually rises and falls during the process of breathing.
• The peak of the cough is at night, most often this is the third or fourth hour of the night.
• If you attach a hand or ear to the baby's chest clearly, rattles are heard.
• The child has a fever, a hoarse voice and a constant cough - all these symptoms can lead to a primary insufficiency of breathing. A sign of insufficiency is a cyanotic shade of the skin around the nose and lips (cyanosis).

Laryngitis can be contagious, provided that it is provoked by a viral infection. As is known, the method of transmission of the virus is airborne, therefore during the period of the baby's illness it is necessary to observe the ventilation regime. Treatment of the disease is directly due to the diagnosis and form of the process. Therapeutic measures designate the attending physician, parents need to remember that independent attempts to stop laryngitis are fraught with suffocating attacks of the baby. In general, fever, hoarseness of the voice can not be considered as a sign of a health risk, mild forms of laryngitis are treated within 10-14 days and do not require therapy in the hospital.

The baby has a runny nose and a hoarse voice

If the child has a runny nose and hoarse voice, dry cough is associated with these symptoms, speech, most likely, is about laryngitis. Rare and transparent discharge from the baby's spout is often accompanied by pain in the throat, a general malaise. However, these signs are not homogeneous and can point to such root causes:

• Inflammatory process in the larynx.
• GERD (gastro-oesophageal reflux), wheezing is preceded by nausea, in toddlers of infancy - frequent regurgitation.
• SARS without laryngitis, hoarseness and runny nose are incoming, temporary symptoms.

According to statistics, most often symptoms are hoarse voice in the child, there is a runny nose and cough, indicate laryngitis. Inflammation of one or another zone of the larynx is not uncommon due to seasonal outbreaks of viral diseases. The nasopharynx of young children does not have an active local immune defense, therefore, in infants, apart from the standard "set" in the form of cough and hoarseness, nasal discharge is quite often observed. The clinical picture of the disease depends on the type of inflammation of the larynx, the types of laryngitis are as follows:

• Qatar. This is the most easily tolerated disease in which parents notice that the child has a runny nose and hoarse voice, but the body temperature is not increased and overall health does not change for the worse.
• Hypertrophic (nodular) form of inflammation is characterized by persistent cough, severe discomfort in the throat. The child complains of a malaise, the appetite is tart. This process is peculiar to children in the adolescent period, especially boys often suffer from dysphonia.
• Functional laryngitis is never accompanied by a runny nose, so we mention it in the article for comparison and differentiation of the root cause. It is more likely to overstrain ligaments during singing sessions, hoarseness may trigger a cry, long crying, but in this case - not a viral or bacterial infection.

The classic signs of laryngitis are, first and foremost, nasal congestion and runny nose, followed by coughing and coughing itself, which together leads to a change in voice - hoarseness. Moist secretions can be not only nasal, but also when coughing, the productivity of cough begins on 3-4 days. In general, a simple form of laryngitis lasts no more than 10 days provided timely diagnosis and compliance with the recommendations of the treating doctor.

The child has a hoarse voice and barking cough

Signs of malaise - a child hoarse voice and barking cough, should alarm the attentive parents. The hoarseness itself may not be related to the disease, but a characteristic cough, a persistent cough, wheezing sounds during breathing - all this indicates a risk of developing the so-called "false cereal".

To distinguish the symptoms of croup from the signs of typical viral infections, let's take a closer look at the causes, the development of the disease and the characteristic "markers".

Hoarseness of the child, why does this happen?

Kids have specific anatomical differences, the structure of their organs, the structure of tissues is special. So, the larynx of babies and children up to 3-4 years is rather narrow, the mucosal vocal folds are not sufficiently formed, the lymphadenoid tissue is loose, vulnerable and prone to rapid swelling. Any virus, bacterial infection or exposure to an allergen provokes a reaction in the form of an edema, spasm, plica vocalis (vocal cords) close and impede the breathing process. In addition, it is this state of the larynx that leads to a change in the timbre of the voice - hoarseness.

Pediatricians usually talk with parents of infants, explaining that any uncharacteristic sound released by the child, a cough that resembles "barking" is the reason for an immediate call of a doctor. In a word, it is necessary to remember:

• Laryngospasm is dangerous.
• The disease can provoke rapid flow of mucous tissue.
• The spastic process is the risk of blocking the intake of air, the risk of suffocation.
• Signs of a false groin - an occasion for immediate hospitalization of the kid.

The main signs of laryngospasm:

1. The child has a hoarse voice and a barking cough.
2. The baby can hardly breathe.
3. The child's breathing is accompanied by specific sounds similar to whistling.
4. The color of the facial skin can change in the child, especially in the area of the nasolabial triangle (cyanosis, blueness).
5. The difficult process of breathing is visible firsthand - the stomach in the epigastric region is retracted.
6. Attacks of false croup often occur at night, stop and repeat with a frequency after 25-30 minutes.

The child has a hoarse voice, there is a barking cough, what should I do?

• Call a doctor, emergency ambulance.
• Ask the doctor of the council what actions to take before his arrival.
• Before the arrival of the doctor, periodically give the baby a warm drink, often in small portions (with a spoon).
• Raise the child's body, giving it a vertical position (take in hand).
• Try to ventilate the room, moisten the air.
• Do not give cough syrup, other medication without a doctor's recommendation.

As a rule, everything passes within 3-4 days, the forecast is successful, provided that you timely contact specialists and implement their recommendations.

The child has a sore throat and hoarse voice

The pain in the throat, which is combined with perspiration and hoarseness, can be a sign of various diseases. Let us list those who most often provoke the symptom "the child has a sore throat and hoarse voice":

• ARVI.
• Laryngitis, which develops against the background of acute respiratory infections.
• Pharyngitis.
• Laryngotracheitis.
• Epiglottitis.
• Tonsillitis.
• Overvoltage of the vocal folds (functional state).

Leading in this list is laryngitis, as the most often diagnosed nosology. However, the pain symptom in the throat indicates that, most likely, the child has pharyngitis. A more accurate diagnosis, of course, can only be done by a doctor, we will only consider possible options for the development of the process.

How to distinguish between tonsillitis, pharyngitis and laryngitis, if a child has a sore throat and hoarse voice?

First of all, the difference between the above diseases in the anatomical zone of inflammation:

1. Tonsillitis is an inflammatory process of pharyngeal tonsils.
2. Laryngitis is an inflammation of one or another zone of the larynx.
3. Pharyngitis is an inflammatory disease of the pharynx.
4. Epiglottitis - an inflammation of the zone of epiglottis cartilage (epiglottis).

There are similarities in these diseases, almost all of them are provoked by the same factors - a viral infection (parainfluenza, influenza, adenoviruses) or bacterial infection (staphylococci, streptococci). Epiglottitis in children up to 7-9 years "drops out" of the etiological community, it is provoked by a specific wand Haemophilus influenzae type B. In schoolchildren, the inflammation of the epiglottis is also provoked by viral or bacterial infections.

The most characteristic signs of pharyngitis are a painful sensation when eating, when swallowing, the chronic form of pharyngitis is fraught with a specific voice timbre - hoarseness.

What are the factors provoking the symptoms - "hoarse voice in the child", "sore throat"?

1. Pharyngitis in a chronic variant. Causes:
   • Weak immune defense.
   • The constant effect of irritating factors - air pollution, fungal spores, dust.
   • Chronic sinusitis, rhinitis.
   • Tonsillitis.
   • Frequent ARVI.
   • Allergy.
2. Laryngitis. Provoking reasons:

• The acute form can be independent because of strong hypothermia, functional tension of the ligaments (screaming, crying). Also, acute inflammation is provoked by parainfluenza, measles, bacterial infections.
• The chronic course of the inflammatory process develops against a background of rhinitis, sinusitis, or sluggish ARD.

1. Epiglottitis is caused by viral, bacterial infections, hemophilic rod, and also because of cardiac pathologies.

If the child has a sore throat and hoarse voice, you need to watch the baby for several hours. Disturbing signs that call for a doctor are:

• Intensified salivation.
• Swelling of the throat, lymph nodes.
• If the child can not swallow even liquid food.
• Wheezing, shortness of breath.
• Pain symptom in the throat, which does not disappear, but grows.
• Body temperature is steadily increasing and approaching 38 degrees.
• The child has a characteristic "barking" cough.

An accurate diagnosis and identification of the cause is the sphere of activity of specialists, usually the disease is determined quickly enough on clinical grounds, and timely treatment ends with the complete recovery of the baby.

A hoarse voice in the child's mucus in the throat

Mucus in the throat and hoarseness are clinical manifestations or acute forms of catarrh in the larynx (catarrhal laryngitis), or allergic reaction, but also the symptom "hoarse voice in the child and mucus in the throat" may be a sign of any other disease caused by viruses or bacterial infection. Exact diagnosis is carried out by a doctor, most often a primary examination takes place at a pediatrician's reception, then an otolaryngologist is connected. Hyperemic mucous tissue, the presence of mucus - this is the visible parameters of the process. Talking, questions to parents, measuring body temperature, in short, collecting an anamnesis confirm the primary version of the diagnosis. Specification, if required, is carried out in the format of laboratory tests, less often the child is laryngoscopy.

Usually mucosal discharge is a manifestation of acute respiratory viral infection, laryngitis, ENT diseases, but also LFR (laryngopharyngeal reflux), which in children is often encountered recently.

A list of etiological factors that can trigger the symptoms of "hoarse voice in a child, mucus in the throat":

1. Pharyngitis.
2. Allergy.
3. Bacterial, viral or fungal infection.
4. Adenoiditis.
5. Sinusitis.
6. Laryngitis.
7. LFR (laryngopharyngeal reflux).

Since viscous or diluted sputum in the presence of hoarseness is primarily a "companion" of laryngitis, consider some of its species.

• Acute inflammation of the larynx occurs due to acute respiratory disease, acute respiratory viral infection, or due to excessive load on the ligaments.
• The chronic course of laryngitis is characterized by the involvement of submucosal tissues in the process, which the child is not completely formed.

You should pay attention to such options for inflammation of the larynx:

1. Laryngitis caused by infectious disease, it can be fraught with abscesses. This is especially typical for streptococcal infection.
2. Croup is a guttural true (diphtheria). The disease is quite rare, however, the risk of its appearance remains. Most often diphtheria affects children up to 4-5 years. The bacillus Corynebacterium diphtheriae provokes a serious lesion of the mucous tissue, the appearance of a specific mucus, a film. The disease starts with the usual symptoms similar to ARVI, which greatly complicates the timely diagnosis and carries a risk of life threatening.
3. Laryngitis as a consequence of measles, scarlet fever or whooping cough. In addition, that hoarse voice and mucus in the throat, with measles immediately visible eruptions on the child's body. If the baby has a pinpoint eruption and a specifically bright "crimson" tongue, mucous discharge and hoarseness, he may have contracted scarlet fever. Pertussis is characterized by coughing spasms, they lead to a change in voice, activation of mucus secretion.

The most easily tolerated by the child is catarrhal laryngitis, in which there is a symptom - a hoarse voice and mucus in the throat, however, adequate medical measures quickly bring the condition of the baby back to normal.

[13]

Complications and consequences

The consequences of the symptom "hoarse voice in a child", the complications directly depend on the etiological provoking factor. One of the most serious consequences is laryngospasm, bronchospasm. Most often, suffocation, a spastic condition are signs of a so-called false cereal.

Let's list his "signals":

• Dry persistent cough, attacks which intensify at night.
• Blue around the lips, in the nasolabial triangle.
• Shortness of breath, whistling specific sounds during breathing.
• Uncharacteristic movements of the chest of the baby during breathing.
• A hoarse voice, hoarseness.
• Periodic increase in body temperature.
• General lethargy, poor health.

The child's voice is hoarse. What consequences and complications can there be?

• The acute phase of the disease, which causes hoarseness, can go into a chronic, protracted form with the development of infectious inflammation in the nearby sectors (trachea, bronchus).
• The untimely appeal for medical help in case of a false rupture is fraught with a serious threat to the child's life. Suffocation, which ends fatal, fortunately, is very rare. However, the mere fact of finding a baby in a state of shortage of air negatively affects many of its organs and systems.
• It should be noted that hoarse voice in the child - this can also be a sign of diphtheria. The disease develops very quickly, rapidly, in the cessation of spasm, every minute is literally in the literal sense of these words. Specific films can completely block the access of air, this is fraught with a deadly risk for the child, especially for babies.
• Stenosis of the larynx, which was not diagnosed and treated in a timely manner, can be transformed into a chronic process that requires already operative intervention. All operations are carried out by modern methods, almost painless, nevertheless, even after the most skillful manipulation on the walls of the larynx, scarring may remain.

The consequences and complications may not bother the child or his parents at all. It is possible, if any anxiety signal of a malaise is supervised by the attending physician, and the treatment is performed accurately, carefully, according to all recommendations.

[14], [15]

Diagnostics of the hoarseness of the child's voice

Diagnosis of any disease is a complex of the doctor's actions. Diagnosis of a child's hoarse voice is no exception. The hoarse voice of a child is just one of the signs, which can be much more when examined closely.

Correct and timely diagnosis is the key to successful recovery of the baby. What does the doctor do to identify the cause of the disease?

Diagnosis of a child's hoarse voice includes such items:

1. Interrogation of parents, information collection (epidemiological history), analysis of received information.
2. Primary examination of the mouth, throat, nose.
3. Palpation of the neck, chest, cervical lymph nodes.
4. Determining the tone of the neck muscles.
5. Stethoscopy (the doctor listens to the child's breathing with a stethoscope).
6. Talk with the child to determine the change in the characteristics of the voice.
7. Measurement of body temperature.
8. If necessary, laryngoscopy can be prescribed, and laryngostroboscopy (ligament vibration testing) is less common.
9. If hoarseness is associated with psychoemotional shock, it is possible to test the psychologist, consult a neurologist.
10. If necessary, the pediatrician can direct the child to the phoniatrist, the speech therapist.

If the doctor was called in time, the identification of the disease occurs quickly, often the first survey without additional procedures and tests is sufficient.

[16],

Analyzes

As a rule, the symptom of "hoarse voice in a child" does not require analysis. Analyzes may be needed in case of differentiation of the diagnosis, its clarification for choosing the most optimal path of treatment.

Diagnosis consists in standard actions:

• Anamnestic information.
• Visual examination of the child's body, examination of the mouth, nose, throat.
• Palpation of the lymph nodes.
• Determine the level of voice changes.
• Listening to breathing noises, chest palpation.

All this helps the experienced doctor to make an initial conclusion and prescribe, or exclude the need for additional examination, including analyzes.

Usually, tests for hoarseness are needed in such cases:

• Suspicion of a bacterial infection of the throat, larynx. Bacterial sowing is prescribed, a swab is taken from the throat. To exclude diphtheria, a culture is carried out on BL (diphtheria bacillus).
• An immunogram can be recommended if the child is included in the FBD category - often ailing children or in its status an allergy has already been determined. The result of the complex analysis helps the doctor to choose the optimal vector of treatment, including to activate the immune defense.
• If the inflammation occurs in an acute form, it is necessary to pass the UAC (general blood test) to determine the presence or absence of leukocytosis. An elevated level of leukocytes is a direct indication of the inflammatory process, the ESR also changes, lymphocytosis appears.
• In case of suspicion of epiglottitis, the doctor prescribes bacteriological sowing (smear) from the throat, as well as sowing on specific anaerobic, aerobic sticks based on blood material. In addition, during the treatment of epiglottitis, the child's health status should be monitored continuously, including by means of CBS-determining the blood pH, determining the gas composition of the arterial blood (pressure and oxygen percentage, carbon dioxide pressure, HCO3-anion level).

[17], [18], [19], [20],

Instrumental diagnostics

Instrumental diagnosis in the presence of the symptom "hoarse voice in a child" is prescribed in case of combined signs of the disease. The doctor for differential diagnosis sometimes requires additional examinations, for example, endoscopy, laryngoscopy.

What is a simple laryngoscopy?

Larynx, throat is examined using a specific probe - an endoscope, the examination helps determine the level of deformation of the larynx mucosa, vocal folds. In addition, during laryngoscopy, the doctor has the opportunity to take tissue material for a biopsy, if necessary. The procedure is very effective as a diagnostic part, however it is not applicable for children from birth to 7-10 years. Therefore, endoscopic examination is often used in diagnostic practice. Modern medical equipment allows you to carry out the procedure with little or no pain and discomfort to even infants. One of the "leaders" in this endoscopic series is fibroendoscopy. The procedure can help to see the condition of the larynx, pharynx, nose.

What kinds of instrumental diagnostics are used in ENT practice?

• Mirror laryngoscopy (for children over 10 years and adults).
• Stroboscopy, videostroboscopy - to assess the flexibility, mobility of the voice fold (not suitable for young children).
• Fibroendoskopiya - visual inspection of all areas of the larynx, nasopharynx.
• Mikrolaringoskopiya - in exceptional cases. The procedure is carried out with the help of anesthesia. We need this procedure for emergency diagnosis of babies who are not able to withstand this "measure" because of mobility, emotionality, fear. Also, microlaringoscopy is needed for a thorough examination of the anatomical structure of the larynx (the structure and shape of the glottis, the condition of the ligaments, the closure) or for therapeutic manipulation in this zone.
• X-rays of the larynx are prescribed extremely rarely and in the main to adult patients to exclude serious pathological changes in the larynx.

Instrumental diagnostics helps to specify the sector of the inflammatory process, exclude serious pathologies (papillomatosis, congenital anomalies of the laryngeal structure) and prescribe an effective course of treatment for the symptom of "hoarse voice in a child".

Differential diagnosis

Differential diagnosis is needed to take timely measures to treat the baby.

The child's voice is hoarse, there is a cough, the general condition worsens. How can you independently determine what happened? Of course, an accurate diagnosis can only be made by a specialist on the basis of a complex of examinations. Nevertheless, in order to remove anxiety, parents should know what distinguishes pharyngitis, bronchitis, sinusitis, tonsillitis, laryngitis and other diseases occurring in the larynx, throat. As a rule, many acute respiratory infections affect at once 2-3 respiratory tract sectors, that is, against a background of tonsillitis, for example, pharyngitis or tracheitis may develop, the virus provokes laryngitis and so on. Combined inflammatory processes affect the health of the child and are expressed in such symptoms:

• Obvious general weakness, fatigue.
• The child often has a sore throat and hoarse voice.
• Pain is present when swallowing food, or between meals.
• Due to the general intoxication of the infection, hyperthermia (elevated body temperature) may develop.
• The baby begins coughing, coughing dry, often goes to the lower respiratory tract.
• Breathing becomes uneven, heavy.

Most respiratory pathologies affect no more than two sectors, for example, the larynx and the trachea. Often there is a combination of laryngitis and tracheitis - laryngotracheitis. If the infection penetrates below, the doctor makes a diagnosis - tracheobronchitis. The spread of the infectious pathogen goes from the top down - from the nasopharynx to the bronchi. It is important to determine the root cause in time and stop the process.

Ohrip voice in the child, differentiate the symptomatology and try to find out - what happened.

Symptom	Laryngitis	Bronchitis	Tracheitis	Pharyngitis
Is the body temperature elevated?	Possible subfebrile body temperature	Body temperature rises in acute form	The temperature rise is possible up to 28 degrees, but this happens rarely	Subfebrile body temperature, acute form - up to 38-39 degrees
Sore throat	Pershit throat, no pain	Practically not found	Sensation of irritation, worse with coughing	Almost always, especially when swallowing
The voice changes the characteristics	A hoarse voice in a child is a typical symptom of laryngitis	Rarely	Rarely	Rarely. Possible hoarseness, slight hoarseness with coughing
There is a cough	Dry, specific cough - barking. Attacks of cough at night	Dry cough gradually turns into a cough with sputum	Frequent, unproductive, dry, at night and in the morning	Very dry, rare cough
Breath	Spastic dyspnea	Dyspnoea with bronchospasm	Respiratory spasm when coughing	Breathing rarely changes

Differential diagnosis should also include a number of examinations that exclude or confirm - allergies, diphtheria, congenital anomalies of the anatomy of the larynx, gastroesophageal reflux, in which hoarseness can also be observed. To clarify the diagnosis, additional laboratory tests, instrumental methods of examination help.

Treatment of the hoarseness of the child's voice

After examinations, a set of diagnostic measures the doctor prescribes treatment of a hoarse voice in the child. Contrary to the popular opinion of many parents, the symptom "hoarse voice in a child" does not usually require antibiotic treatment. Such therapy is prescribed only after studies on the bacterial flora and after the identification of a specific causative agent of infection. It should be remembered that self-medication, especially when it comes to the baby, is extremely risky and dangerous. The most optimal option is to call a doctor, examine the child and get clear recommendations for treatment from a specialist.

The standard treatment of a hoarse voice in a child can be as follows:

• Symptomatic therapy - neutralization of elevated body temperature (above 38 degrees), vitamin preparations to maintain the general condition, with spasms of a combined nature (bronchospasm) - bronchodilators to reduce active laryngeal edema.
• Gentle voice mode (silent mode).
• Ventilation and humidification of air in the room.
• Exceptions to the risk of allergic effects.
• Gentle diet with the exception of hot, hot dishes.
• Frequent, fractional copious drink.
• Inhalations with the inclusion of mineral waters, herbal infusions, specific drugs that remove swelling of the mucous larynx.
• Rinses, throat irrigation.
• If the child's wheezing voice as a result of an allergic reaction, antihistamines are prescribed.
• Immunomodulators can be prescribed to activate the body's resistance, immune protection, improve general condition.
• Expectorants are needed only in the case of determining the inflammatory process in the trachea or bronchi.
• Antibiotics only according to indications depending on the detected infectious agent, age and condition of the child.
• Physiotherapeutic procedures are needed to fix the therapeutic effect and reduce the severity of the symptoms.

Treatment of a hoarse voice assumes specific parameters - the age of the baby, the presence or absence of additional diseases in the anamnesis, the anatomical features of both the body and the structure of the larynx, the allergic status, the severity of the inflammatory process and its localization. If necessary, the doctor prescribes treatment of a hoarse voice in combination with therapy of concomitant pathologies, for example, in diagnosed gastroesophageal reflux. A good result is an additional sanation of the nasopharynx, as more often hoarseness, cough is a consequence of chronic ARI. Microsurgical intervention in detecting nodular pathology of ligaments, papillomatosis, polyps in the treatment of children is extremely rare. Surgery can be effective only in cases where the stenosis of the larynx is rapidly developing and there is a threat to the life of the baby. The standard of treating hoarse voice in a child is conservative therapy.

What if the baby has a hoarse voice?

What can parents do, what if the child has a hoarse voice?

The most disturbing symptom of hoarseness in children aged from birth to 5-6 years. The larynx is not yet formed, there is a danger of a spasm of the respiratory tract, so attentive mom and dad should immediately call the doctor at the appearance of the first signs - hoarse voices, dyspnea, cough.

Often hoarse voice in a child is a clinical manifestation of one of the types of laryngitis, except for a voice there may be such signs:

• First there is a general malaise, usually it is called a cold.
• Laryngitis rarely develops as an independent disease, it is a consequence of ARVI.
• If you look into your child's mouth, you can clearly see swelling, reddening of the mucous throat, larynx.
• The baby has heavy breathing, shortness of breath.
• There is a sore throat when swallowing.
• The child coughs, cough dry, unproductive, frequent.
• Cough paroxysmal, worse at night.

What if the baby has a hoarse voice?

• First of all, to reassure the baby, to ensure the most gentle voice mode, silence mode.
• Exclude from the food hot dishes, irritating the mucous tissue products.
• Provide an abundant fractional drink (warm, purified water, decoctions, water from a spoon in small portions, often every 15-20 minutes).
• Ventilate the room, try to ensure a normal level of humidity.
• Remove all that can provoke a cough, choking, remove allergens (flowers, pets, feather pillows, duvets, soft toys).
• If there is no heat and dangerous symptoms, hold the inhalation with mineral water, decoction of chamomile.
• In time, the initiated measures, examination of the doctor and the implementation of the doctor's recommendations help to improve the child's condition literally within 2-3 days. Self-medication, the use of unproven recipes, following the advice of "grandmothers", girlfriends - is the risk of starting a disease that can go into a chronic form with complications.

Pay attention to the following information:

• If there is severe shortness of breath, whistling sounds during breathing, you should immediately call a doctor, most often - emergency help. It is better to be safe and to exclude a false cereal from the baby.
• Before the arrival of a doctor, you can warm the child's legs, this will ensure the outflow of blood from the upper respiratory tract and ease the condition.
• Before the doctor visits you, you need to give your child a drink from a spoon - a fractional warm drink after 15-20 minutes.

Medications

Medicines in the tablet form in the treatment of the symptom "hoarse voice in the child" are most often not used. Medications can be drugs that are used for inhalation or rinsing of the throat.

1. So, the simplest rinse is a solution of furacilin. Antimicrobial drug for topical application has long been known and well-proven. It is used to rinse the throat, including for children, since the moment the child has a way to perform the rinsing procedure in principle. With regularly performed measures of throat sanitation, furacilin is able to essentially replace an antibiotic, neutralizing many pathogenic microorganisms. Rinses are carried out 4-5 days in a row 2-3 times a day. Recipe - a glass of boiled warm water is 0.02 furatsilina. The tablet is pulverized and thoroughly stirred in water.
2. As a rinse aid, chlorophyllipt is used. This means of natural origin, perfectly fights bacteria that can provoke ARVI and laryngitis. The antiseptic effect of chlorophyllipt is well known to the pediatrician, and they often designate this drug as a safe and effective means for rinsing the toddlers
3. Miramistin is considered an excellent drug. The drug has a wide range of effects on viruses, microorganisms and even on fungal infection. In addition, Miramistin helps to increase the activity of local immune defense, which is important in the hoarseness of the voice, the deterioration of the general condition of the child. Miramistin can neutralize irritation in the throat, with course treatment, remove the symptom of "hoarse voice in the child, reduce the intensity of cough, sanitize the glands and mouth
4. No less effective are spray preparations, for example, Bioparox. Active active substance fusafungin has an antimicrobial effect, is very effective against streptococci, staphylococci, fungal infection.

Here is a list of drugs that effectively reduce the intensity of hoarseness, but before using them, you should consult your doctor:

Antiseptics:

• Rotokan.
• Pharyngept.
• Lizobakt.
• Bioparox.
• Hexaspree.
• Inhaliptus.
• Chlorophyllipt.
• Decaturene.

Contraindication to the appointment of irrigation with medicines, to the use of sprays, may be the age of the child or allergic reactions to the components of the drug. The most safe - Bioparox, Lisobakt, Chlorophyllipt. All antimicrobial, antiviral drugs require the choice and presence of a physician.

For specification, you can add:

• Treatment hoarseness - a conservative.
• More often in therapy of children phytopreparations, medicines of a natural origin, a homeopathy are used.
• Antibiotics of the latest generation, a broad spectrum of action can be prescribed only by a pediatrician, an ENT doctor according to the indications. As a rule, drugs in aerosol form are sufficient, including in the composition of antimicrobial, antibacterial components.
• Oral administration of antibiotics is an extreme measure when all of the above actions do not lead to positive dynamics.
• With dry persistent cough, antitussive syrups can be recommended - Broncholitin, Doctor MOM, Lazolvan. Bronchodilators are prescribed cautiously taking into account anamnesis and clinical picture of the disease, otherwise they can provoke serious complications, up to laryngospasm, bronchospasm.
• If the wheezing of the child's voice due to allergies, the course of treatment includes antihistamines - Zirtek, Claritin. Dosage and mode of reception is determined by an ENT doctor or allergist.

Vitamins

Vitamins are needed in treatment not so much as a symptom - a hoarse voice, a child, as a rule, this is a consequence of ARVI and other ENT pathologies. Vitamin therapy helps to activate the protective functions of the body, improve the overall condition of the baby. Laryngitis as the most common cause of hoarseness of the voice is good and fairly quickly treated, especially its catarrhal variant. Pediatricians can appoint complexes of vitamins, vitamins in the form of tablets, capsules, in liquid form, less often - as an injection, it all depends on the clinical picture of the disease and the age of the child. The most effective vitamins C, A, E, group B, vitamin D and calcium.

Consider a list of vitamins that help cope with laryngitis:

1. Retinol or vitamin A. Helps the vital activity of almost all cells of both internal tissues and external skin. Increases immunity resistance during the invasion of pathogenic infections.
2. Thiamine, vitamin B1. Regulates the exchange of amino acids, carbohydrate balance, affects the nervous system, stabilizing it.
3. Riboflavin, vitamin B2. It participates in enzymatic processes, helps the recovery of mucous tissues, utilizes used substances, including "spent" amino acids. This vitamin is especially important for normalization of the nasopharyngeal mucosa, oral cavity, larynx.
4. Pyridoxine hydrochloride, vitamin B6. Normalizes the protein balance, improves enzyme reactions, stabilizes the central nervous system, activates the process of hematopoiesis
5. Cobalamin, vitamin B12. Normalizes enzymatic processes, participates in the process of hematopoiesis, improves the state of the nervous system, normalizes the digestive processes.
6. Ascorbic acid, vitamin C. The leader in the list of vitamins, it probably knows even those who do not understand the medical nuances. Magnificent immunomodulator, antioxidant. Helps the body in resisting many infections, helps to activate the immune system.

Vitamins in the treatment of hoarseness are auxiliary activities. To choose the form and type of vitamin preparations will help the attending physician. Such vitamins for children are popular:

• Jungle Kids.
• The alphabet "Our baby".
• Pikovit.
• Vitrum.
• Kinder Biovital.
• Oligovit.
• Multi-tabs.
• Unicap

Physiotherapeutic treatment

The child's hoarseness is one of the clinical manifestations of a primary disease, which is most often laryngitis, a catarrhal form. Physiotherapeutic treatment for hoarseness is aimed primarily at eliminating the risk of laryngospasm, the task of physiotherapy can also be stabilization and consolidation of the therapeutic effects of conservative treatment.

Inhalations, rinses can be carried out at home, but more serious procedures require an outpatient visit to special rooms. To cure laryngitis is to eliminate the root cause, and the symptomatology is perfectly treated with the help of physiotherapy and home procedures.

Let's enumerate the types of physiotherapeutic treatment:

• Inhalation - both at home and in the doctor's office.
• Irrigation of the throat with special means.
• UHF - removes puffiness, reduces the intensity of inflammation, promotes a faster recovery of the mucous tissue of the larynx.
• Electrophoresis, often it is prescribed as an anesthetic measure with discomfort, pain in the throat (electrophoresis with novocaine).
• Microwave therapy, improving cellular metabolic processes, activating local immune defense.

The complex application of physiotherapeutic treatment always has a beneficial effect on the healing process. Hardware methods accelerate the regeneration of larynx tissues, relieve puffiness. This is due to the specific nature of the reflex response of the body to the stimulus, which is used in physiotherapy. The transformation of one or another type of thermal action (electrical impulse, thermal or mechanical stimulus) positively affects virtually all biological functions of the child's body.

Physiotherapeutic treatment is appointed taking into account such parameters:

• General condition of the child, anamnesis and diagnosis.
• Features of the disease, which provokes a symptom - hoarse voice in the child.
• Sex and age of the child.
• Specificity of psychoemotional status.
• Physiotherapy is contraindicated in the period of exacerbation of the disease, with all pathologies occurring in acute form.

Alternative treatment

Folk, home treatment of symptoms - hoarse voice in a child, cough, perhaps provided that you use proven, safe recipes.

We offer you several of them:

1. Rinses - broth of violets and chamomiles (on a teaspoonful of inflorescences, boil with boiling water - 200 ml of water, insist 10 minutes, cool to a warm kind). Rinse 3 times a day for a week.
2. Inhalations with sage broth. (1 tablespoon of herbs poured 250 ml of water, boiled for 5 minutes, filtered). Inhalation should be given to children older than 2, 5 -3 years, usually a steam procedure.
3. Warm, frequent drinking of herbal decoctions. !! A teaspoon of anise seeds mixed with a teaspoon of chamomile. Filled with 500 ml of water, boiled for no more than 5 minutes. The broth should be allowed to brew for 30 minutes, drain and water the baby from the spoon for 1-2 days every 3 hours (2 teaspoons of broth).
4. Lime tea. Lipa is rightly considered to be the "queen" of phlegmatic cough suppressants. Children like it because of its pleasant taste and aroma. Dried flowers of lime (2 tablespoons) pour 400 ml of water, bring to a boil, cool to a warm state, add 4 tablespoons of honey (provided that the child is not allergic). You can drink this tea at will, as long as the baby wants, but at least 2-3 days.

Do not get carried away by heating the chest, including alternative means - mustard plasters, compresses. This can worsen the condition of the child. A typical, safe measure is rinsing with herbal decoctions, irrigation of the throat or inhalation with herbal remedies.

Note that the symptom of "hoarse voice in a child" may be just a temporary sign of ligament overload, so starting a home treatment is better with a regular gargling. If the symptoms worsen, further treatment will help to choose a pediatrician.

[21]

Homeopathy

Homeopathy in the treatment of the root cause of the symptom - hoarse voice in the child, is used quite widely. Especially if it is about the therapy of babies in the age of 3-4 years.

Dysphonia (hoarseness of voice) needs complex therapeutic measures, which include homeopathy. An excellent effect is provided by homeopathic remedies in the supervision of functional dysphonia, when there is no obvious pathological cause for hoarseness, but it is caused by overload of ligaments or nervous stress.

Homeopathy in the treatment of both laryngitis and functional disorders is a means, which are called drugs of choice. Only a doctor with a special education and experience in this area can prescribe.

Let's list some preparations from a category of homeopathic, however, it is necessary to remember, that independent their use is not recommended.

1. Homeowax. The composition of the drug in walks aconite, iron phosphate, arizema, beladona, burnt sponge, poplar, calendula. In fact, there is nothing unnatural in the medicine, except that aconite and belladonna are poisonous plants. Therefore, appoint a homeopathic doctor. Dosage and methods of administration are also his prerogative. All the dysphonia associated with overloading the vocal fold, functional laryngitis are well treatable. The duration of the course of treatment lasts no less than a month.
2. Calcarea iodate. It helps with chronic laryngitis, persistent cough .. It is used in combination with Hepar sulfur for 7 to 10 days, the dose is prescribed by a homeopath.
3. Gepar sulfur - effective at low temperature, hoarseness, reduced appetite.
4. Silicea - is effective in the treatment of all chronic forms of ARVI. It is combined with hepar sulfur, treatment lasts from 7 to 10 days, the dosage depends on the child's age.

Homeopathy can be either in the form of a dragee, or in the form of a liquid. For young children, the liquid form is preferable, grains, pellets can also be dissolved in pure boiled water in the proportions recommended by the doctor.

Prevention

Prevention of symptoms of laryngitis, a sign - hoarse voice in a child, it's all activities to maintain a healthy baby's immunity, ensure normal nutrition, physical activity.

Since many reasons provoking hoarseness are associated with viral infections, disease prevention consists in careful and regular airing of the premises in which the baby is. Also important is wet cleaning, dry air often exacerbates the clinical manifestations of the disease. Vitamins play no less important role. The food of the child should be rich in a complex of natural vitamins, which are necessary for the growing organism of microelements.

Even if the child has hoarse gloss, the baby is ill and diagnosed with laryngitis, the disease rarely lasts more than 10 days. After 3-4 days his condition improves, breathing and voice are restored. Prevention is necessary in order to avoid relapse, repetition of the disease.

Basic rules of prevention:

• Hardening, corresponding to age indices.
• Regular examinations at the pediatrician, sanation of the throat, nasopharynx if necessary.
• Strengthening the protective functions of the baby's body.
• Wet cleaning and ventilation of premises.
• Physical mobility, activity. Let the child play, run, do not shield him from normal, age-old habits.
• Normal sleep and eating.
• Positive atmosphere in the family, any nervous breakdown, shocks can provoke a symptom - hoarse voice in the child.

[22], [23],

Forecast

If the child has a hoarse voice, the prognosis is usually favorable, the treatment does not last more than a week and the baby quickly recovers. More serious consequences can have - false croup, protracted chronic inflammatory processes that provoke hoarseness, and the forecast is less favorable for congenital anatomical defects of the larynx. The prognosis after surgical manipulations is also positive, modern medicine allows to carry out operations sparing way without obvious and complex damages of tender tissue of the larynx.

In general, the child's hoarse voice is just a sign that can be caused by commonplace reasons. For example, a toddler is anxious, nervous and screams for a long time, older children suffer a peculiar hoarseness at a preschool age or at school. Emotionality, activity, mobility of children is the basis for violent reactions, which are often expressed in the voice. If the child screams with joy, laughs hoarsely, perhaps this phenomenon is most favorable in the list of causes of hoarseness. We wish your children health and a good, sonorous voice, appropriate to age and temperament.

[24]