Dysphonia in preterm children: assessing incidence and response to treatment
Victoria Reynolds1, Suzanne Meldrum2, Karen Simmer3
1School of Paediatrics and Child Health, University of Western Australia, Australia; Speech Pathology Department, Princess Margaret Hospital for Children, Western Australia, Australia.
Insights
This study investigates childhood dysphonia in very preterm children, using objective voice assessments and a voice therapy trial. Findings will inform clinical practice for this vulnerable population.
Area of Science:
- Pediatric Otolaryngology
- Neonatal Medicine
- Speech-Language Pathology
Background:
- Moderate to severe childhood dysphonia is rare, often linked to medical conditions or intubation injury.
- Very preterm infants may require intubation, but dysphonia in this group is understudied.
- This research addresses a gap in understanding voice disorders in very preterm children.
Purpose of the Study:
- To objectively assess voice quality and its impact on quality of life in very preterm children.
- To determine the incidence and nature of laryngeal pathology in children with dysphonia.
- To evaluate the efficacy of behavioral voice therapy for dysphonia in this population.
Main Methods:
- Phase 1: Voice quality and quality of life assessment in up to 200 children born <32 weeks gestation.
- Phase 2: Laryngeal pathology assessment via fiber optic evaluation for moderate to severe dysphonia.
- Phase 3: Randomized controlled trial of behavioral voice therapy.
Main Results:
- This study is the first to use objective acoustic voice assessment in a pediatric dysphonia study.
- It will document the incidence of dysphonia in very preterm children at school age.
- It will conduct a controlled trial of behavioral voice therapy.
Conclusions:
- This research pioneers clinical assessment and fiber optic evaluation for very preterm children's voice quality.
- Participants with voice difficulties will be randomized for immediate or delayed therapy.
- Findings will provide crucial insights into pediatric dysphonia management.
Background:
Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population.
Design:
This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia.
Discussion:
This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment.
Trial Registration:
This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763).
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