Ear, nose and throat (ENT) and voice services

Children with voice disorders (dysphonia) are seen in close conjunction with the ENT department.

All children seen must be under the care of a Great Ormond Street Hospital (GOSH) consultant.

We see children with voice disorders associated with voice misuse, such as vocal fold nodules, as well as less common childhood voice disorders associated with psychological issues, organic pathologies like childhood papillomatosis and vocal fold palsy, congenital conditions, such as laryngeal web and laryngomalacia, and airway disorders.

Children referred to the Joint Paediatric Voice clinic are seen jointly by an ENT consultant and Specialist Speech and Language Therapist.

As part of a comprehensive assessment, the child's larynx is examined using rigid endoscopy and/or flexible nasendoscopy with laryngographically synchronised stroboscopy.

The clinic aims to identify the cause of the voice problem, to describe the structure and movement of the larynx and to evaluate appropriate courses of management and to make recommendations for ongoing management in collaboration with local services.

Referrals are received nationally and internationally from Consultants and General Practitioners. Children are typically over six years of age but younger children may be seen.

A small caseload of children with complex voice disorders are seen for voice therapy at Great Ormond Street Hospital.

However, wherever possible, the department’s philosophy is that children should be referred to their local speech and language therapy service for treatment where co-ordination with schools and other agencies involved in the child’s care is most appropriately managed.