Hoarseness in children.

Hoarseness or dysphonia are terms used to describe a change in the quality of the voice. The voice quality can be raspy, breathy, strained, fatigued, rough, tremulous or weak. There may be a change in pitch, restriction of range, voice breaks, decreased projection, or abnormal resonance. It is important to remember that a voice disorder is not a disease in itself but rather a presentation of an underlying pathology. Clinicians' knowledge of paediatric hoarseness is limited as it can be difficult to examine children using fibreoptic laryngoscopy and the child may not comprehend the need for detailed examination. However, paediatric flexible naso-laryngoscopy provides a dynamic view of the laryngeal anatomy and function. Recent advances in diagnostic equipment, pharmacology and therapeutics mean that this problem can be managed more successfully but it still remains a challenge. This article discusses the presentation, aetiology and management of hoarseness in children.