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Pediatric Rounds Review Questions
An 18-Month-Old Boy with Progressive Hoarseness

Answer 1

  1. Dysphonia that is worse in morning may suggest gastroesophageal reflux laryngitis. Acute hoarseness (< 2 weeks’ duration) is commonly caused by self-limiting viral infections; thus, a posture of expectant observation usually is most appropriate during this period. Neonatal dysphonia associated with stridor usually indicates a congenital anomaly or neuromuscular disorder. Longstanding hoarseness is often caused by vocal nodules. Hoarseness that lasts more than 2 weeks, is progressive, or is associated with aphonia or stridor may indicate a neoplasm or other serious disorder and should be evaluated promptly.

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