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Recurrent aphonia in schoolchildren

Dysphonia is a change in voice quality due to different problems of the larynx. It is the typical hoarse voice.

The aphonia is when, when trying to speak, the sounds do not come out. They are very frequent in school children (6-7 years). It is when they start the group activities. They decrease at puberty , which is when vocal molting occurs.

Boys suffer more than girls.

Functional or benign dysphonia is the most frequent: it is caused by the misuse of the voice. And it improves with the rest of it.

How does our voice work?

The sound of the voice is produced when the vocal cords vibrate. They are two bands of fibrous tissue found in the larynx. When you don’t speak, the vocal cords open to breathe. When we talk, they stay together and the air in the lungs passes through them and makes them vibrate. These vibrations produce sound waves. And when passing through the throat, nose and mouth (which act as a resonant chamber) the sound is modulated.

What are the causes?

There are several circumstances that cause aphonia or dysphonia:

  • The  misuse and abuse of voice  is the main cause of dysphonia in children. Overexertion that the child makes when speaking, singing or shouting results in a malfunction of the vocal apparatus. This, together with dry environments,  tobacco smoke  or ambient noise make it worse. That’s why they often have aphonia.
  • The  acute laryngitis  is another frequent cause of hoarseness. It is due to temporary inflammation of the vocal cords due to  colds , respiratory infections or  allergies .
  • Laryngitis  gastroesophageal reflux . Heartburn goes up the esophagus. When it reaches the larynx it irritates the vocal cords. Causes dry cough especially at night and aphonia in the morning.
  • The  nodules in the vocal cords  also cause dysphonia. They are produced by the repetition of hoarseness pictures. This leads to a progressive inflammation of the vocal cords and the nodules are formed.

What are the warning signs in children with dysphonia?

It is important to know these alarm signs. In case they appear, it is necessary to consult with the pediatrician:

  • Sore throat or pain radiating to the ear.
  • If it lasts more than 2 weeks.
  • If there is difficulty swallowing or breathing.
  • Dysphonia in children under 2 years.
  • Weightloss.
  • If you do not respond to treatment.

How is it treated? 
The treatment is individual. It depends on the cause. It will be the pediatrician who guides us.
If aphonia is recurrent, it may be necessary to be assessed by an ENT doctor. With a laryngoscope you can see the vocal cords in motion and thus know what the problem is.

  • In the case of acute laryngitis in a few days it is resolved. They recover completely.
  • If they are due to allergy, they are treated with antihistamines and corticosteroids .
  • Gastroesophageal reflux improves with antacids .
  • Functional dysphonia, due to misuse of the voice, requires vocal hygiene guidelines. The speech therapist is the professional specialized in this treatment.
  • In the vocal nodules an expectant attitude is taken: vocal hygiene and phonological rehabilitation guidelines are given with one or several cycles. Most disappear with puberty. The surgery is left for cases that do not improve.

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