Hseu Anne, Ongkasuwan Julina
Boston Children's Hospital, 300 Longwood Avenue, BCH 3129, Boston, MA 02115, USA.
Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin, Suite 640, Houston, TX 77030, USA.
Otolaryngol Clin North Am. 2019 Oct;52(5):949-956. doi: 10.1016/j.otc.2019.06.006. Epub 2019 Jul 25.
Pediatric dysphonia is common; however, not all vocal fold pathology in children is due to nodules. Laryngeal stroboscopy (transoral or transnasal) often is essential for the diagnosis of other not-nodule lesions. As in adults, multidisciplinary care with a speech language pathologist helps with patient buy-in for therapy. Breathy dysphonia due to glottic incompetence may be related to vocal fold movement impairment (VFMI) or posterior glottic insufficiency. There are several medialization procedures available for children with VFMI due to recurrent laryngeal nerve injury.
小儿发声困难很常见;然而,儿童并非所有声带病变都是由小结引起的。喉动态镜检查(经口或经鼻)对于诊断其他非小结病变通常至关重要。与成人一样,由言语语言病理学家进行多学科护理有助于患者接受治疗。由于声门功能不全导致的呼吸性发声困难可能与声带运动障碍(VFMI)或后声门闭合不全有关。对于因喉返神经损伤导致VFMI的儿童,有几种声带内移手术可供选择。