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Relationship between voice quality and vocal nodule size.

Rahul K Shah¹, Samuel H Engel, Sukgi S Choi

¹Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA. rshah@cnmc.org

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|November 6, 2008

Summary

Larger vocal nodules in children significantly reduce pitch range. However, other voice quality measures do not significantly differ with nodule size, suggesting complex rehabilitation needs.

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Area of Science:

Pediatric Otolaryngology
Speech-Language Pathology
Voice Science

Background:

Vocal nodules are common in children and can affect voice quality.
The relationship between vocal nodule size and specific voice characteristics is not fully understood.

Purpose of the Study:

To investigate the impact of vocal nodule size on voice in pediatric patients.
To correlate vocal nodule grade with objective and subjective voice measurements.

Main Methods:

Vocal nodules were graded by three pediatric otolaryngologists using a validated scale.
Data from 40 pediatric patients diagnosed with vocal nodules between 2003 and 2007 were analyzed.

Main Results:

A statistically significant reduction in pitch range was observed in patients with larger vocal nodules (P = 0.001).
No significant association was found between nodule grade and fundamental frequency, perturbation, shimmer, respiratory support, air loss, or muscle tension.
Several voice measures showed a trend towards significance with increasing nodule size.

Conclusions:

Vocal nodule size primarily impacts pitch range in pediatric patients.
Objective and subjective voice measurements, apart from pitch, do not significantly differ across varying vocal nodule sizes.
Voice rehabilitation for children with nodules is complex and may not directly correlate with nodule size.