Vocal nodules in children: Laryngoscopic morphological classification aids prognostic judgment

Area of Science:

• Otolaryngology
• Pediatric Medicine
• Speech Pathology

Background:

• Vocal fold nodules (VFNs) are benign lesions affecting children's vocal cords.
• Prognosis and treatment for pediatric VFNs remain subjects of debate.
• A need exists for indicators to assess prognosis in pediatric cases.

Purpose of the Study:

• To investigate correlations between clinical factors and the laryngoscopic morphology of VFNs in children.
• To identify indicators for predicting prognosis and guiding treatment for pediatric VFNs.

Main Methods:

• Retrospective analysis of 194 pediatric patients diagnosed with VFNs.
• Data collected included patient demographics, duration of dysphonia, and related conditions (e.g., allergic rhinitis, LPR).
• Correlation analysis between clinical factors and VFN morphology observed during laryngoscopy.

Main Results:

• Vocal nodules were the primary cause of phonation disorders in 93.27% of analyzed children.
• Longer dysphonia duration was associated with more mature (p=0.026) and discrete (p=0.022) nodules.
• Boys showed a higher prevalence of mature (p=0.050) and discrete (p=0.008) nodules.
• Recovery time was significantly related to age (p=0.000), dysphonia duration (p=0.000), and nodule morphology (p=0.000).

Conclusions:

• Vocal nodules are the most frequent cause of pediatric phonation disorders.
• Laryngoscopic morphology aids in clinical diagnosis and treatment selection.
• Active treatment is recommended for older children with longer-duration dysphonia and mature, discrete nodules.