Home Health Care What Was Causing a Toddler’s Vocal Problems? Not Any of the Usual Suspects

What Was Causing a Toddler’s Vocal Problems? Not Any of the Usual Suspects

by Carol Polovoy
Cute child thinking

When a toddler presented with a raspy voice, pediatricians initially suspected respiratory infections, dysphonia and then acid reflux. But, as revealed in a “Mystery Diagnosis” column in the Washington Post, the problem was much more serious.

A pediatrician initiated acid reflux treatment and referred the little girl, who had experienced voice problems since birth, to a a pediatric otolaryngologist.  The ENTs investigations revealed a diagnosis that shocked the girls’ parents: She had a rare disease—recurrent respiratory papillomatosis. Caused by two strains of the human papilloma virus (HPV)—a sexually transmitted infection acquired at or before birth—the incurable disease causes benign tumors in the respiratory tract, most commonly in the larynx.

The papillomas interfere with the normal vibrations of the vocal folds and may block the airway.


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Treatment includes surgery to shave off the tumors, which grow back. The procedure, which may need to be repeated two or three times a year, can damage the vocal cords.

The article describes a newer method to remove the tumors, potassium titanyl phosphate laser, which can remove more tumor while minimizing vocal cord damage.

Carol Polovoy is managing editor of The ASHA Leader. cpolovoy@asha.org

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