Prevalence of Dysphonia in Children: A Systematic Review and Meta-Analysis

Objectives: To analyze the prevalence of pediatric voice disorders.

Study design: Systematic review (SR) and meta-analysis.

Methods: The research question of this SR was "What is the prevalence of dysphonia in children?" An electronic search was performed using the Medical Literature Analysis and Retrieval System online (Medline), Literatura Latino-Americana e do Caribe em Ciências da Saúde, EMBASE, Web of Science, and SCOPUS database. A manual search was performed in gray literature (ProQuest and Banco Digital de Teses e Dissertações) and through the mapping of references. Studies that analyzed the prevalence of dysphonia in children with outcomes such as the overall degree of vocal deviation, laryngeal endoscopic imaging, acoustic analysis, and vocal self-assessments in the global context were included. The risk of bias was verified using a checklist of prevalence studies. A meta-analysis was performed using proportion analysis, and statistical heterogeneity was calculated using I² and t².

Results: The initial search identified 796 articles, and 16 were selected. The risk of bias analysis showed that 62.5% (n = 10) of the articles had low methodological quality. The total prevalence of dysphonia was 15% based on the overall degree of vocal deviation, 29% based on laryngeal endoscopic imaging, 10% based on vocal self-assessment, and 19% regardless of the type of assessment performed. High heterogeneity was observed for all evaluation forms.

Conclusion: Children have a high prevalence of dysphonia. Studies on the prevalence of pediatric voice disorders have low methodological quality, and the prevalence rates obtained in these studies are heterogeneous, thus compromising the validity and generalization of the results.