An integrated approach to the diagnosis of voice disorders in children

Objective. To substantiate a comprehensive diagnostic approach within the framework of the clinical standard for voice disorders in children.
Materials and methods. The algorithm was developed based on a retrospective analysis of patients' clinical data (anamnestic information, results of subjective and objective assessment of vocal function) obtained during the examination of children of the Belarusian population aged 4–12 years.
Results. It was revealed that during the collection of medical history from parents, it is necessary to focus on the risk factors for hearing loss, as well as on the presence of somatic pathology accompanied by voice disorders. The necessity of using the Voice Handicap Index questionnaire and expert assessment of the child's voice by both the parent and the doctor (Fischer test, p = 0.0) is proved. Dissociation of the informational significance of laryngoscopy (13.0 %) was established in comparison with the expert assessment of voice (76.9 %) and qualitative and quantitative parameters of acoustic analysis of voice (100.0 %); The revealed differences between diagnostic methods are statistically significant (p < 0.05 for all paired comparisons). The diagnostic value of acoustic voice analysis indicators (F0_SD, Jitter, and Shimmer) in diagnosing a child's voice disorder has been proven. A method for diagnosing dysphonia in children has been developed (the instructions for use “Method for diagnosing dysphonia in children” include a subjective and objective assessment of children's voices with clearly defined criteria for detecting voice disorders).
Conclusion. The study proved the expediency of introducing into clinical practice a comprehensive diagnostic algorithm for children with voice disorders, which includes both subjective methods and objective techniques (acoustic analysis and laryngoscopy). This approach minimizes the risk of diagnostic errors and increases the effectiveness of subsequent rehabilitation.

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