<s>[INST] Hi. My 5 year old daughter has had a really hoarse voice since yesterday. We do have a history of seasonal asthma, but no problems this last fall which was great! Now she started to have a really hoarse voice, no fever, complains of bottom front of the neck hurting when she talks but not when she swallows. She also has been followed for what we were told a osteosarcoma on her clavicle. We did miss the last follow up. Now it seems the end of the clavicle nearest to the throat is larger than the other side and she complains its sore when touched. What is going on? Laryngitis or something else? Her pulse ox is reading ok...between 95-99 but or prbpm is going from 50 up to 125 down to 65 and back up again. Let just say its all over the place. Help! [/INST] Asthma is not the reason for her hoarse voice. This could either be laryngitis or involvement of the vocal cords or the nerve that supplies the vocal cords for proper functioning of the cords. This nerve is known as the recurrent laryngeal nerve, and it is part of the tenth cranial nerve (the vagus nerve). It descends into the chest in front of the lungs and goes very close to the clavicles inner end. Take her urgently to her primary physician who may refer her to the correct specialist. </s>