title: Prevalence of Voice Disturbances in the Pediatric Craniofacial Patient Population.
abstract: To report on the prevalence of voice disturbances in the pediatric craniofacial population and to prove that the pediatric Voice Handicap Index (pVHI) is a useful questionnaire for this unique population.
  
  
  
  Case series with chart review.
  
  
  
  Tertiary care center.
  
  
  
  Pediatric patients seen by a pediatric otolaryngologist in a craniofacial clinic.
  
  
  
  Consecutive patients (N = 366) seen by a single pediatric otolaryngologist in a craniofacial clinic from July 2011 to September 2012 were included. Any patient specifically referred for airway problems or voice difficulties completed a pVHI questionnaire. Patients each underwent an evaluation including flexible fiberoptic laryngoscopy and videostroboscopy. Voice disturbance was further characterized into dysphonia, hypernasality, or hyponasality.
  
  
  
  Of all the patients evaluated, 280 (77%) were specifically referred for airway problems or voice disturbance. Of those referred, 39 (10.7%) were found to have an organic vocal fold pathology causing dysphonia, as seen on the videostroboscopic examination; 53.7% of these lesions were attributable to potential iatrogenic causes. Hypernasality and hyponasality were seen in 116 (31.7%) and 78 (21.3%) patients, respectively. The pVHI was 3.95, 26.3, 11.34, and 10.53 for those with no voice disturbance, dysphonia, hypernasality, and hyponasality, respectively.
  
  
  
  Pediatric patients with craniofacial disorders have a higher prevalence of dysphonia than the general pediatric population. The majority of causes of dysphonia in these patients are possibly iatrogenic in origin. The pVHI serves as a useful questionnaire in this unique patient cohort to quantify the disability from not only dysphonia but also hypernasality and hyponasality.
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, New York, New York, USA mark.andrew.fritz@gmail.com.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Fritz
authors.affiliation: Department of Otolaryngology, New York University School of Medicine, New York, New York, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Rickert
mesh_terms: D002648:Child; D019465:Craniofacial Abnormalities / Q000150:complications*; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D049489:Stroboscopy; D014832:Voice Disorders / Q000453:epidemiology* / Q000209:etiology*
keywords: craniofacial; dysphonia; otolaryngology; pVHI; pediatrics; resonance disorder; velopharyngeal insufficiency; voice disturbance