HOARSENESS IN CHILDREN
Hoarseness and voice problems in general that last longer than about 6 weeks should be examined competently. The cause for hoarseness in children is often due to improper voice use and voice misuse.
WHAT IS HOARSENESS?
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Hoarseness and voice problems in general that last longer than about 6 weeks should be expertly investigated. The cause for hoarseness in children is often due to improper voice use and voice misuse.
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Children who often shout (at home, during their hobbies, on the playground), sing loudly a lot, often make goofy, growling or squeaky voices are at higher risk for hoarseness.
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HOW DOES AN EXAMINATION TAKE PLACE?
A consultation at the Voice Clinic consists of 2 parts: a voice examination with the speech therapist and a voice and visual examination with the NKO doctor. You do not have to be sober for the examination.
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Usually, you will be seen by the speech therapist first. You will be asked to do some speech and singing exercises into a microphone. The microphone may be in front of you or like headphones on your head. The speech therapist will assess the quality and any defects or abnormalities in the voice by listening and taking measurements on the recorded voice.
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Next, you will see the ENT-doctor. First, another vocal test is done so that the doctor can also listen from a medical point of view to how the voice sounds and where any problems can be heard. A microphone will be placed on your head for this purpose. You will be asked to read a text aloud, so be sure to bring your glasses.
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For the visual examination of the vocal cords, the nose and throat are numbed locally. At the level of the nose, this is done with a nasal spray that also opens the nose wider. The throat is numbed with drops or spray through the mouth. You may feel that this causes the throat to swell and make it more difficult to swallow or breathe. This is not the case, but is due to reduced sensation in the throat. This way, the ENT-doctor can get close enough to the vocal cords to see what is going on.
The visual examination can be done in 2 ways. A first possibility is with a "flexible camera", in which the camera sits on the tip of a soft, bendable tube inserted through the nose (see image). The second option is with a "rigid camera" that is inserted through the mouth. The camera is connected to a screen. During the examination, you will be asked to perform voice commands. The keyhole examination lasts between 5 and 10 minutes. Throughout the examination, you can continue to breathe, speak and swallow smoothly. It is important to follow the ENT-doctor's instructions carefully.
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After the visual examination, you should wait half an hour to an hour before eating or drinking to avoid choking. After 1 hour you may take a sip of cold water. If you do not cough, it means that the anesthesia has worn off and that you can eat and drink as before.
bron: shutterstock
HOW DOES THE EXAMINATION PROCEED IN CHILDREN?
To the extent possible, it may be helpful to prepare your child for the examination by going through the steps together. In children, a "flexible camera" is used that is thinner than the adult version and better suited to the narrower passage through a child's nose. The first part of the examination, where the camera passes through the nose, can sometimes cause a tickling sensation in the nose because this is the narrowest part. This can be compared to water entering the nose while swimming. It is important to keep the head well still and not pull the camera out of the nose, otherwise this narrowest part must be repassed several times. Once in the throat, most children have little trouble with the camera. If you wish, you can take the child on your lap or stand next to your child.
THERAPY
If your child needs speech therapy for the voice, it is usually only feasible and useful from the age of 8 to 10. This is because children must learn to apply the techniques learned at the speech therapist's office in everyday speech. Speech therapy for voice disorders is reimbursed once in a lifetime per condition. It is the view of the Voice Clinic that this reimbursed session is then better started at an age when it can have an effect.
Of course, you are welcome to visit the Voice Clinic with your child to check what is causing the hoarseness. If necessary, our speech therapists can already give you some tips and tricks to apply at home.