Hoarseness refers to abnormal voice changes such as changes in loudness or tone. Hoarseness in children may simply be due to repetitive screaming and yelling, which irritates the vocal cords but usually goes away without medication. However, pay attention to your child when hoarseness persists or when it is present with other symptoms, such as drooling. When hoarseness occurs at the same time with drooling, it could be an indication of something more serious.
Trauma to the Neck
Trauma to the neck area can cause the most urgent situation in which sudden hoarseness and difficulty swallowing are found. Trauma that causes these symptoms may include nerve damage, ingesting certain chemicals and foreign object penetration. Laryngeal area, or vocal cords, damage may lead to tissue swelling, which prevents normal vocal cords' function. Air then passes through a narrower airway. The results are a husky or scratchy voice and swallowing difficulties. If the swelling is not treated immediately, it can lead to complete closure of the vocal cords and thus prevent breathing. In these life-threatening situations, seek immediate medical attention for your child.
Gastrointestinal Reflux, and Viral and Bacterial Infections
Other situations causing inflammation of the vocal cords include gastrointestinal reflux, and viral or bacterial infections. Gastrointestinal reflux is when stomach acid comes up and irritates the vocal cords, causing inflammation when left untreated. Laryngitis is the most common cause of hoarseness in children and is usually from a common cold or infection of the upper respiratory tract. Whereas epiglottitis is an infection of the epiglottis, the flap at the bottom of the throat. Both laryngitis and epiglottitis usually present with a fever and sore throat in addition to hoarseness and drooling.
Abnormal Growth
The most serious case in which drooling and hoarseness are present are abnormal growths on the vocal cords, such as cysts, papillomas, polyps and nodules. Vocal nodules are common in those who need to raise their voice for performance. Polyps and cysts might lead to cancer, although it is uncommon. When hoarseness is due to these growths, it usually persists and does not go away by itself.
Medical Procedures
Certain medical procedures can cause hoarseness and drooling as well. During intubation and bronchoscopy, medical equipment is inserted through the vocal cords, damaging this area even when the procedure is done appropriately. Although the resulting swelling can occur in both children and adults, it is more serious in children because their airway is narrower. The inflamed tissue can swell up the airways to the point where air can no longer pass through and reach the lungs. Therefore medical personnel usually stand by during extubation in case swelling occurs.
