Our patient was a 12-year-old who presented to our clinic with the complaint of hoarseness for a duration of 9 months after a sore throat. Prior to that, she was well. Unlike the typical presentation in recurrent respiratory papillomatosis, when the child tends to present earlier, at the age of 4 or 5 years old, her onset of hoarseness started when she was 12 years old. It was progressively worsening. Fortunately, she did not have any associated airway issues. She was able to eat and drink normally, and there was no suggestion of recent weight loss. The risk factors for hoarseness, such as vocal abuse, talking, and singing loudly, were also not present in her case.
Examination
A perceptual evaluation of voice quality using GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) was performed. She was given a score of G: 3 R: 3 B: 0 A: 3 S: 1. Her only complaint was hoarseness. She was otherwise well. There were no signs of airway distress and no feeding issues. Her growth centile was appropriate for her age. There was no family history of a similar disease. We performed a flexible nasoendoscopy on her. There was a lesion seen on her right vocal cord as shown in the picture. This lesion was well-circumscribed with a smooth mucosal surface. There were no other abnormalities. Her vocal cord movements were normal.
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