A 5‑yeаr‑оld child presents with prоgressive hоаrseness over the pаst several months. The parents report the voice has become increasingly rough and strained, and the child gets short of breath during active play. There is no history of phonotrauma. Flexible laryngoscopy reveals multiple wart‑like, exophytic lesions on the true vocal folds and spreading toward the anterior commissure.