Hoarseness is quite common in children. It is usually related to the way children use their voices rather than a serious illness.
It is common after URTIs.
Common causes include:
- Infections
- Vocal cord nodules (“screamers nodules”)
- Other laryngeal pathology such as cysts/polyps/papillomas etc
Acute onset of hoarseness associated with stridor could be a sign of an inhaled foreign body or more serious infectious disease.
Chronic hoarseness
- Refer to community speech and language therapy
- Treat any associated bacterial infection (consider antibiotics where appropriate).
- Consider possibility of reflux/silent reflux and treat with PPI
Voice rest is not recommended. Gentle humming and good hydration should be encouraged.
When to refer:
Urgent to A & E
- Acute hoarseness with respiratory distress or stridor
Routine to SALT
- Hoarseness persists for > 3 months marked deterioration in voice quality.
Routine to ENT
- Significant hoarseness from birth (? respiratory papillomatosis)
- Hoarseness/weak cry/aspiration after surgery e.g. cardiac surgery.
