The Impact of Nasal Patency on Vocal Fold Nodule Formation in Children

Area of Science:

• Otolaryngology
• Pediatric Voice Disorders
• Respiratory Physiology

Background:

• Vocal fold nodules are common in children, often linked to voice misuse and environmental factors.
• Nasal obstruction can alter breathing patterns, potentially impacting airway health and phonation.
• Understanding the relationship between nasal patency and vocal fold nodules is crucial for comprehensive pediatric care.

Purpose of the Study:

• To endoscopically evaluate adenoid obstruction, mucous coverage, and inferior turbinate hypertrophy in children with vocal fold nodules.
• To compare nasal patency parameters between children with vocal fold nodules and a control group.
• To investigate potential links between nasal breathing patterns and the development of vocal fold nodules.

Main Methods:

• Retrospective analysis of 54 children diagnosed with vocal fold nodules (2022-2024).
• Flexible nasofiberoscopy and tympanometry were performed.
• Medical history and clinical data were reviewed.

Main Results:

• Children with vocal fold nodules exhibited significantly less frequent snoring (p=0.003) and open-mouth breathing (p=0.004) compared to controls.
• Pathological adenoid mucous coverage was more prevalent in the nodule group (p=0.02).
• Mean adenoid size (A/C ratio) was smaller in children with vocal fold nodules (52.1%) versus controls (63.4%, p=0.01).

Conclusions:

• Pediatric vocal fold nodules are associated with smaller adenoids, reduced snoring, and less mouth breathing.
• Increased pathological nasal mucus is a common finding in children with vocal fold nodules.
• A direct causal link between mouth breathing due to nasal obstruction and vocal fold nodule formation could not be established in this study.