Since her hoarseness has been present for the past two years, the cause will be benign. Is it still worsening or stable now? Was this hoarseness preceded by any infection, trauma or illness two years ago? Chronic infection of the larynx and throat secondary to adenoid hypertrophy and chronic tonsillitis should be ruled out. Does she have a history of mouth breathing or snoring at night? A videolaryngoscopy can help rule out vocal nodules, phonatory gaps, vocal cord paralysis, paresis, oedema. cysts, polyps, webs, laryngeal papilomatosis and many other rarer causes. GERD (Gastro Esophageal Reflux Disease) can affect children too. Does she have chronic cough? " I diamond I swallowed" may refer to a foreign body ingestion and "a lot of spit in my throat when I sleep" may refer to a post nasal drip, reflux, allergy or nasal obstruction. (We swallow less when asleep). "It hurts there after I eat" may also refer to chronic infection / inflammation due to a combination of some of the above factors. Please get these investigations done along with x-rays of the neck and for adenoids and post your results here.