Pediatric Pediatric VideostroboscopyVideostroboscopy

ENT Department. Hospital de Niños “J.M de los Ríos”.Caracas- Venezuela

Dr. M.Adriana Pérez, Dr. Victoria Tenías, Dr. Jacqueline Alvarado, Dr. Ligia Acosta, Dr. Yanet bastidas, Dr. Marisol Díaz

Well known use of videostroboscopy Minor Structural Alterations of larynx (Paulo Pontes

Brasil 1994): Laryngeal Asymmetry Posterior fusion incomplete Glottic disproportion Alteration of focal fold cover

Chronic Dysphonia Congenital origin?

BackgroundBackground

Design a protocol for performing videostroboscopy in children

Point out usefulness of previous training for children below 8 years old

Precise incidence of minor structural alterations of larynx in pediatric population

ObjectivesObjectives

Prospective and descriptive study Aug 2008 - Aug 2009 165 Dysphonic patients 33 patients (+24m) Between 4 and 18 years old / 21 M – 12 F Exclusion criteria.:

Cranial and facial dimorphism Puberphonia Laryngeal Papillomatosis Vocal fold paresis Laryngeal previous surgery

Methods IMethods I

History of Dysphonia

Methods IIMethods II

History of Dysphonia

Methods IIMethods II

Transnasal Flexible Fibroptic evaluation

Methods IIMethods II

Aritenoids mobility

Vocal fold

Lesions

Videostroboscopic assessment: Mother training/child training: minimal 2 weeks Gag reflex: metoclorpamide if needed

Methods IIMethods II

Methods IIMethods II

ResultsResults Distribution of Minimal Structural Alterations in

patients with dysphonia

N= 165

ResultsResults

N= 33

Distribution by age of patients with minimal structural alterations

ResultsResults Distribution of minimal structural alterations

types

ResultsResults Number of failed intents by age

-All patients trained.-21% (7) needed “ a second chance”-9% (3) needed a “ third chance”-Ages 7 to 10 more affected-More frequent lesion: sulcus vocalis-All (33 pts) had Minimal Structural Alterations.

ConclusioConclusionsns

- Videostroboscopy can be done in pediatric patients-Minimal structural alterations could have a congenital origin-Voice therapy can be follow up in children's-Management of dysphonic patients could be done more accurately in pediatric patients

ConclusioConclusionsns

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