Related Experiment Videos
Pediatric dysphonia: It's not about the nodules.
Joseph E Dohar1, Amber D Shaffer2, Katherine E White3
1Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
International Journal of Pediatric Otorhinolaryngology
|July 20, 2019
Summary
Vocal nodule grade does not correlate with voice severity in children. This suggests current grading may not reflect the true causes of childhood dysphonia, necessitating further research into underlying drivers.
Area of Science:
- Pediatric Otolaryngology
- Speech-Language Pathology
- Voice Science
Background:
- Vocal nodules are a common cause of chronic dysphonia in children, yet diagnostic and management decisions remain uncertain.
- Optimal staging systems are crucial for understanding disease progression and treatment outcomes in pediatric voice disorders.
- The prognostic model for vocal nodules in children is currently debated.
Purpose of the Study:
- To analyze the predictive power of vocal nodule grade on voice metrics severity in children.
- To investigate the correlation between vocal nodule size and objective/subjective voice assessments.
Main Methods:
- Retrospective analysis of 79 children diagnosed with vocal cord nodules (2006-2012).
- Data collected included age, nodule grade, comorbidities, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores, Pediatric Voice Handicap Index (pVHI) scores, phonotraumatic behaviors, habitual pitch, pitch range, volume intensity, and s/z ratio.
- Statistical analysis using Kruskal-Wallis H Test and Chi-squared tests.
Main Results:
- No statistically significant correlation was found between nodule grade and total pitch range (p=0.21).
- No significant associations were observed between nodule grade and s/z ratio (p=0.50), volume intensity (p=0.33), overall CAPE-V scores (p=0.15), or pVHI scores (p=0.29).
- Nodule grade did not significantly correlate with abnormalities in habitual speaking pitch (p=0.14-0.76).
Conclusions:
- The current grading system for vocal nodules does not appear to drive the standard dysphonic metrics monitored in children.
- Findings support the prudence of avoiding surgical treatment for vocal nodules in children due to limited evidence of nodules driving dysphonia severity.
- Further research is needed to identify the true drivers of dysphonia in children to develop more targeted therapies.