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Aim of work This is a cross sectional case control study to asses vocal folds abnormalities and voice analysis in asthmatic children to detect subclinical changes and to correlate them with their various clinical and functional grading and level of control. Methods the study included 48 asthmatic children (34 males and 14 females ) regularly attending Pediatric chest Clinic, Ain Shams university for follow up.Their median age was 7.8 years ± 2.15 IQR. A 12 age and sex matched healthy children were chosen as control group. For all patients and control the following were done: history taking,General and chest examination, Spirometry Pulmonary functions(FEV1,FVC,), videolaryngoscopy (VLS)and Multidimensional voice analysis (MDVA) . Results VideoLaryngoscopy (VLS) of asthmatic patients showed different abnormalities in 26 cases ( 54.2% ).eg Phonatory west 1mm from the middle line(4 cases), Bilateral vocal folds nodules (4 cases), Bilateral thickening of both vocal folds(3 cases), Vocal fold cyst.(4 cases). Asthmatic children with abnormal finding in (VLS) had a statistical significant lower values of FEV1 and MMEF with higher percentage of poor asthma control. Voice analysis showed impairment of voice acoustics in asthmatic children with significant difference between asthmatic and control as regards voice analysis data with significant higher jitter and shimmer dB (measure of voice amplitude and detector of early hoarseness of voice) . Conclusion Asthmatic patients may have an associated Laryngeal or vocal folds abnormalities which are considered a comorbid condition and one of the causes of poor asthma control. Voice analysis may help in detection of subclinical hoarseness of voice which may be sequelae of chronic cough or side effects of inhaled steroids.

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