Hao Meng Yip, Lesley-Ann Cochrane, Lesley Cavalli, Emily Gallagher, Nicola Gorb, Christopher G Jephson
Children commonly experienced prolonged symptoms before specialist review, with a heterogeneous diagnostic spectrum and frequent vocal fold immobility. Standardised outcome capture and longer follow-up are needed to evaluate interventions and inform referral guidance.
BACKGROUND: Paediatric voice disorders encompass a broad diagnostic spectrum, but contemporary descriptions of multidisciplinary voice clinic case-mix, assessment and management remain limited.
METHODS: We performed a retrospective observational study of routinely collected clinical data from a quaternary multidisciplinary paediatric voice clinic in the United Kingdom. Children and adolescents aged 4-17 years who were seen between January 2024 and December 2025 were included. Patient-level variables included demographics, symptom duration, referral-to-first clinic waiting time, and primary diagnosis. Appointment-level variables included documentation of patient-reported outcome measures, endoscopic findings reported in clinic letters, management outcomes, and procedure follow-through.
RESULTS: Of 111 listed appointments, 96 were attended (74 new and 22 follow-up) and 15 were non-attendances. These attended appointments represented 87 patients; median age at first appointment was 12 years (range 4-17 years), and 51/87 (58.6%) were male. Dysphonia was the main presenting symptom in 83/87 (95.4%). Median symptom duration at referral was 6.3 years (range 0.12-17.0 years), and median referral-to-first clinic waiting time was 154 days (range 16-1032 days). The most common diagnoses were vocal cord palsy (19/87, 21.8%), vocal cord nodules (11/87, 12.6%), and muscle tension dysphonia (9/87, 10.3%). In the vocal cord palsy/paresis subgroup (n = 20), 15/20 were left-sided and 13/20 were secondary to post-cardiac surgery/patent ductus arteriosus ligation.
CONCLUSIONS: Children commonly experienced prolonged symptoms before specialist review, with a heterogeneous diagnostic spectrum and frequent vocal fold immobility. Standardised outcome capture and longer follow-up are needed to evaluate interventions and inform referral guidance.