Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Pediatric Otolaryngology

Session: Scientific Oral Presentations 6 - Pediatric Otolaryngology

It Sounds Like Allergy: Correlating Dysphonia and Voice Findings With Atopy in the Pediatric Population

Monday, September 30, 2024
3:00 PM – 3:06 PM EDT
Location: MBCC, 225
Disclosure(s):
Elizabeth B. McCarty, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Richard O. Bourguillon, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kristen L. Zayan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amber D. Shaffer, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Joseph E. Dohar, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The chronic inflammatory state of atopy may contribute to laryngeal nodule development in dysphonic pediatric patients. We analyzed factors associated with atopy and explored the relationship between laryngeal nodules and atopy in pediatric patients with dysphonia.

Methods: A case series with chart review of patients seen in voice clinic at a tertiary care children’s hospital from 2019 to 2023 was conducted. Exclusions were patients seen in voice clinic prior to 2018 (n = 2), age over 18 (n = 4), non-voice related complaints (n = 96), VC immobility (n = 10), hypernasality (n = 6), speech delay/articulation issues (n = 7), and limited information (n = 4). Voice symptoms, allergy history, family atopy history, and PPI/H2 patterns were recorded. Outcomes included scope findings and results of allergy testing. Associations between voice symptoms, scope findings, and atopy diagnoses were examined using logistic regression, t-tests, and Wilcoxon rank-sum with α = 0.05.

Results: A total of 111 patients were identified with with dysphonia. The median age was 6.2 years. Of them, 45 (40.5%) were female, 60 (54.1%) had personal history of atopy (51, 46.0% food/environmental allergy; 10, 9.0% asthma; 8, 7.2% eczema; 5, 4.5% allergic rhinitis; 5, 4.5% EoE; 2 celiac disease). Voice complaints were hoarseness (106, 95.5%) and cough (12, 10.8%). Of the total, 34 (30.6%) were empirically treated with PPI/H2 blocker. Parents reported subjective response to PPI in 8/14 (57.1%). Additionally, 61/109 (56.0%) underwent DLBx, 15/65 (23.1%) were found to have normal scope exam, 24/65 (36.9%) were found to have laryngeal nodules, 6/65 (9.2%) were found to have EoE, and 22/65 (33.9%) were found to have other findings. Of the patients with laryngeal nodules, 14/24 (58.3%) had diagnosis of food/environmental allergy, 2/24 (8.3%) had asthma, 2/24 (8.3%) had celiac, 0/24 (0.0%) had eczema, 0/24 (0.0%) had allergic rhinitis, 1/24 (4.2%) had EoE, 15 had RAST testing and 11 results were positive.

Conclusions: pediatric patients diagnosed with dysphonia are more likely to be atopic. In children who are refractory to voice therapy, diagnosis and management of atopy may be indicated.

    Presenting Author(s)

  • Elizabeth B. McCarty, MD

    Resident
    University of Pittsburgh Medical Center - Medical Education Program
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Richard O. Bourguillon, MD

    Resident PGY3
    University of Pittsburgh Medical Center - Medical Education Program
    PITTSBURGH, PA, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Kristen L. Zayan, MD

    Resident Physician
    University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • IL

    Isabella J. Lao, BS

    Medical Student
    University of Pittsburgh School of Medicine
    Clifton, VA, United States

    Disclosure information not submitted.

  • AS

    Amber D. Shaffer, PhD

    Research Assistant Professor
    UPMC Children's Hospital of Pittsburgh
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • JD

    Joseph E. Dohar, MD

    Medical Director, Pediatric Voice, Resonance, and Swallowing Center
    UPMC Children's Hospital of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.