Evolution of Vocal Fold Nodules from Childhood to Adolescence (original) (raw)
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The prevalence of vocal fold nodules in school age children
Objective: To explore the actual prevalence of vocal nodules among school age children. Methods: A total of 617 children aged from 7 to 16 years were examined. Their voices were recorded and analyzed by using acoustic analysis techniques, and vocal folds were examined by using rigid telescopic laryngoscope. The findings were noted as normal, minimal lesion, immature and mature nodules. Results: Laryngoscopic examination revealed that 430 (69.7%) of the children were normal. Of the remaining 187 children, 82 (13.3%) had minimal lesion, 88 (14.3%) immature nodule, 16 (2.6%) mature nodule and 1 (0.2%) vocal polyp. Comparisons of acoustic parameters revealed that there were no statistically significant differences between normal and minimal lesion groups, and between immature and mature nodule groups. Actual vocal nodule ratios which include both immature and mature nodule groups among whole school children were found to be 21.6% in males and 11.7% in females.
Vocal Nodules and Laryngeal Morphology
Journal of Voice, 2002
Our purpose was to study the occurrence of vocal fold nodules under conditions of habitual vocal abuse associated with increased laryngeal muscle tension, to identify the existence of a relationship between vocal nodules and laryngeal morphology. We studied one group of 30 subjects with vocal nodules, 18 to 50 years old, who were compared with two control groups, one of females and one of males, consisting of 30 subjects each. The parameters evaluated were: type of vocal folds coaptation, glottic proportion (GP) and abduction angle (AA), obtained by videotelelaryngoscopy. In the nodules group, the larynges presented a mean value of GP similar to that of the female group, both of which were lower than the mean GP value of the male group. On the other hand, the mean AA was lower than the one in the female group, and closer to the one in the male group. We concluded that vocal nodules were present only in larynges with a predominantly young female morphology, with functional limitations of abduction.
The Journal of Medical Investigation
Objective : In the present study, an attempt was made to evaluate the acoustic characteristics of voice in pediatric patients with vocal nodules using acoustic analysis of voice. Methods : Thirty-five pediatric patients with vocal nodules and 32 control children without dysphonia were enrolled in this study. Their voice samples were analyzed using the Multi-Dimensional Voice Program. Acoustic parameters of voice, such as pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and noise-to-harmonic ratio (NHR), were measured. Results : In phonation at a loudness of over 80 dBA, the PPQ, APQ, and NHR values of the voice significantly increased in children with vocal nodules than in the control children without dysphonia. The sensitivities and specificities of PPQ, APQ, and NHR for prediction of vocal nodules in children were 62.86% and 84.38%, 74.29% and 75.00%, and 31.43% and 93.75%, respectively. Discussion : The present findings suggest that vocal nodules affect vocal fold vibration, resulting in impaired control of pitch and loudness leading to increased noise components. NHR could be used to evaluate the efficacy of treatment, such as voice rehabilitation, in pediatric patients with vocal nodules because of its high specificity for prediction of vocal nodules in children.
Laryngeal Web as a Possible Cause for Nonabsorption of Vocal Nodules in Boys After Puberty
Journal of Voice, 2018
Objectives. Vocal nodules are frequent in children and tend to be reabsorbed after puberty, especially in boys. The aims of the present study were to analyze the progression of nodules in boys after puberty and to investigate the role of microweb in the persistence of these lesions. Methods. Clinical and videolaryngoscopy evaluations were carried out in boys with vocal nodules treated between 2009 and 2016, followed up to the age of 17 years or until remission of symptoms and reabsorption of the nodules. Boys with vocal nodules who underwent regular vocal therapy are included in the study. The outcomes were remission of symptoms and of the nodular lesions. Results. A total of 34 boys with vocal nodules were diagnosed, of which 21 completed follow-up. Mean age of the first evaluation was 9 years (5-11 years) and of end of treatment was 14 years (13-18 years). Mean number of videolaryngoscopy per child was five. After adolescence there was complete remission of symptoms and of the lesions in 15 children (71.4%), partial remission in four (19.0%), and no remission of symptoms and of the lesions in two cases. In these two, videolaryngoscopy identified the presence of microweb and nodules. Conclusions. Favorable reabsorption of the vocal nodules after adolescence was observed in the majority of the boys who underwent voice therapy; however, in two cases there was no remission of symptoms and of the lesions. The unfavorable course can be attributed to anterior laryngeal microwebs.
Perceptual and acoustic parameters of vocal nodules in children
International journal of pediatric otorhinolaryngology, 2014
Vocal nodules constitute the major cause of dysphonia during childhood. Auditory-perceptual and acoustic vocal analyses have been used to differentiate vocal nodules from normal voice in children. To study the value of auditory-perceptual and acoustic vocal analyses in assessments of children with nodules. Diagnostic test study. A comparative study was carried out including 100 children with videolaryngoscopic diagnosis of vocal nodules (nodule group-NG); and 100 children without vocal symptoms and with normal videolaryngoscopic exams (control group-CG). The age range of both groups was between 4 and 11 years. All children underwent auditory-perceptual vocal analyses (GRBASI scale); maximum phonation time and s/z ratio were calculated, and acoustic vocal analysis (MDVP software) were carried out. There was no difference in the values of maximum phonation time and s/z ratio between groups. Auditory-perceptual analysis indicated greater compromising of voice parameters for NG, compare...
Correlation of Vocal Fold Nodule Size in Children and Perceptual Assessment of Voice Quality
Annals of Otology, Rhinology & Laryngology, 2010
Objectives We examined the relationship between the size of vocal fold nodules and perceptual rating of voice quality in children. Methods We carried out an Institutional Review Board-approved retrospective study in a voice clinic within a tertiary-care pediatric medical center. We studied children seen between 2000 and 2009 with a primary diagnosis of vocal fold nodules as the cause of their voice disturbance. Pediatric vocal fold nodule size was rated with a published validated scale, and voice quality was rated on the Consensus Auditory-Perceptual Evaluation of Voice scale. Results One hundred forty-five patients met the inclusion criteria. Small nodules were noted in 23% of patients, medium nodules in 39%, and large nodules in 37%. Univariate and multivariate analyses demonstrated a statistically significant relationship (p < 0.05) between vocal fold nodule size and rated perceptual qualities of overall severity of voice disturbance, roughness, strain, pitch, and loudness. Wi...
Behavioral Profile of Children With Vocal Fold Nodules-A Case-control Study
Journal of voice : official journal of the Voice Foundation, 2018
The aim of this case-control study was to evaluate the overall behavior of children with vocal fold nodules (VNs). The study group included children with VNs between 4 and 15 years old diagnosed using fiberoptic video laryngoscopy with stroboscopy in a tertiary university hospital. As a control group, children between 4 and 13 years old without VNs, routinely followed up in a primary care facility, were included in the study. Parents of the participants completed the parent-proxy strengths and difficulties questionnaire (SDQ), a brief behavioral screening questionnaire designed for children. The SDQ evaluates emotional, conduct, and peer problems, and also focuses on hyperactivity and prosocial behavior. Children are classified into "normal," "borderline," or "abnormal" according to the total SDQ score. Twenty-seven children (24 boys and 3 girls) with VNs and 41 controls (33 boys and 8 girls) were enrolled in the study. The two groups did not differ sig...
Background: Vocal fold lesions are commonly found in the pediatric age group. The lesions of the vocal fold among children are variable. The laryngoscopic examination is needed for the identification of the vocal fold lesions. The objective of this study is to find out the different vocal fold lesions, clinical presentations, and diagnoses of the vocal fold lesions. Methods: The children aged from 5 to 18 years diagnosed with vocal fold lesions were included in this study. The study was conducted between June 2017 to July 2022. All the children with vocal fold lesions were subjected to video laryngoscopy for assessment of the larynx. Results: There were 156 children diagnosed with vocal fold lesions. The majority of this study's participants were male children (52.56%). The most common symptom was hoarseness. Most common vocal fold lesion was vocal fold nodule (43.58%). Voice abuse was the most common etiological factor behind the vocal fold lesions. Out of 156 children with vocal fold lesions, 72 children (46.15%) underwent microlaryngeal surgery under anesthesia. Voice therapy was given to all the children along with vocal hygiene care. Conclusions: Vocal fold lesions are often found among children. Dysphonia is the commonest clinical presentation of children with vocal fold lesions. Microlaryngeal surgery and voice therapy are two important options for the treatment of vocal fold lesions in pediatric patients.