Instrumental Voice Evaluation in Children: What Are We Getting?
Robert Brinton Fujiki1, Anumitha Venkatraman2, Rachel A Godbout2
1Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis.
Purpose:
The aim of this study was to determine the age at which children with voice disorders can complete videostroboscopy, acoustic, and aerodynamic voice assessments. Factors predicting videostroboscopy tolerance were examined.
Method:
A retrospective observational cohort design was used. Three hundred twelve children with voice disorders were divided into the following age groups: 3-4, 5-6, 7-9, 10-12, and 13-17 years. Videostroboscopy was considered complete if patients produced enough phonation during the exam to allow for stroboscopic ratings of vocal fold oscillation (i.e., mucosal wave, amplitude) to be performed. Patient demographics, voice-related diagnoses, voice symptoms, vocal fold oscillation ratings, clinician experience level, and acoustic and aerodynamic voice measures were collected from the medical record.
Results:
All children tolerated laryngeal imaging under steady-state halogen light. Almost 17% of 3- to 4-year-olds tolerated videostroboscopy. This number significantly increased to 55% in 5- to 6-year-olds (p < .01) and to 60% in 7- to 9-year-olds. Success rates again significantly increased to 85% in 10- to 12-year-olds (p < .01) and 93.1% in children ≥ 13 years old. Age (p = .03) and ability to perform the voice range profile (p < .01) and aerodynamic voice assessment (p < .01) tasks significantly predicted which patients could tolerate videostroboscopy. Half of 3- to 4-year-old children produced sustained phonation for acoustic analyses compared to 91.7% of 5- to 6-year-olds (p < .01). The majority of children ≥ 5 years old completed the voice range profile task (63.3%) and aerodynamic voice assessments (66.7%).
Conclusions:
Videostroboscopy is viable for young children with voice disorders. The ability to complete aerodynamic and voice range profile tasks may serve as a preliminary indicator of how well a patient will tolerate videostroboscopy. Future prospective study may determine the most effective approach to help children tolerate instrumental voice assessments.
