Programs & Services

The Voice Clinic, supported by a multidisciplinary team, works together to assess your child’s voice and breathing.

During your child’s visit, you’ll meet with:

• Pediatric ENT surgeon: Specialist in conditions that affect the ears, nose, throat (ENT), vocal cords and airway. Your child’s ENT surgeon will review their health history, perform a physical exam and help guide next steps. If they recommend in-clinic procedures or follow-up surgery, they’ll explain every detail so you feel confident moving forward.
• Speech-language pathologist: Specialist with expert training in pediatric voice and breathing disorders, including proper evaluation of how your child uses their voice. They teach strategies that may make speaking easier and more comfortable. If voice therapy is part of your child’s care plan, they’ll provide support every step of the way.

During your child’s first visit, we’ll start with a complete evaluation of their voice and breathing. Most children can be evaluated as early as age 4, or once they begin speaking in short phrases. This visit may include voice recordings, breathing assessments and imaging of the vocal cords. These tools help us understand what your child is experiencing and build a care plan that’s right for your child.

Depending on your child’s needs, the visit may include:

• Health and symptom history: We learn about your child’s symptoms, development and medical history.
• Voice recording and acoustic assessment: A speech-language therapist records and analyzes your child’s voice to measure pitch, volume and vocal cord vibration during speech.
• Breathing and airflow (aerodynamic) assessment: We measure how much air your child uses while talking. Your child wears a thin plastic mask over their nose and mouth and repeats simple sounds or syllables.
• Laryngeal videostroboscopy: We use a small camera to record how the vocal cords move and vibrate during speech. We’ll review these recordings with you and store them for future comparison, especially after surgery or therapy.

We work with you and your child to create a care plan that meets their unique needs. Treatment options may include:

Voice Therapy

Voice therapy focuses on exercises and strategies to improve your child’s voice quality and reduce strain. In most cases, your child will start with weekly appointments, which may become less frequent as they progress.

Surgery

If voice therapy or lifestyle changes aren’t enough, surgery may be an option. We perform most procedures endoscopically – with small cameras and instruments through the mouth – so there are no open incisions or visible scars. For some larger airway reconstructions, such as treating tracheostomies or subglottic stenosis, your child may need more extensive surgery.

At Phoenix Children’s, we offer a range of surgical options, including:

• Airway reconstruction: Includes several techniques to widen the airway and, when possible, remove a tracheostomy. These may include laryngotracheoplasty (placing grafts into the airway to make it wider), cricotracheal resection (removing a portion of a narrow or blocked airway to repair it) or tracheal resection/slide tracheoplasty (removing and reconstructing part of the windpipe).
• Arytenoidectomy: Uses a laser to remove extra cartilage above the voice box when it blocks breathing.
• Endoscopic posterior cartilage graft: Helps open the back of the airway for children with paralysis or scarring.
• Laryngeal EMG: A nerve test that helps us learn whether a paralyzed vocal cord may recover function over time.
• Laryngeal web surgery: Removes abnormal tissue bands in the vocal cords so the airway opens normally.
• Papilloma removal: Removes wart-like growths (papillomas) with a laser or other tools. We may also use medication injections to help prevent them from returning.
• Posterior cricoid reduction: Reduces excess airflow after prior airway surgery to help improve the voice.
• Recurrent laryngeal nerve reinnervation: Connects a paralyzed vocal cord nerve to a healthy nerve, restoring tone and helping improve voice long-term.
• Vocal cord cyst or lesion removal: Uses precise instruments to remove growths while protecting the delicate vocal folds.
• Vocal cord injections: Temporarily strengthens and plumps a weak or immobile vocal cord to improve both voice and swallowing.
• Vocal cord lateralization: A minimally invasive way to widen the airway for children with vocal cord paralysis on both sides.

Your child’s ENT surgeon will help you understand all your surgery options and answer any questions.

Simple Lifestyle Changes

Small changes at home can make a big difference in your child’s voice health. Depending on your child’s needs, their care plan may include recommendations like:

• Staying hydrated: Drinking plenty of water helps keep the vocal cords moist and reduces strain during speaking.
• Taking voice breaks: Resting the voice, especially after talking a lot or loudly, gives the vocal cords time to recover. 
• Avoiding yelling or whispering: Both can put stress on the voice. Using a relaxed speaking voice is gentler on the vocal cords.
• Using a humidifier: Adding moisture to dry air can soothe the throat and vocal cords, especially in Arizona’s dry climate. 
• Practicing gentle vocal warmups: For children who use their voice a lot, like for singing, performing or cheering, simple warmup exercises can help prevent strain.

Your care team will provide personalized tips for your child’s age, routine and lifestyle. Many families find that even a few small changes can lead to noticeable improvements.