Impact of Benign Bilateral Vocal Fold Lesions Across Childhood: Does Age Matter?

To assess correlations between age group and functional, physical, emotional, and talkativeness domains of the pediatric Voice Handicap Index (pVHI) in pediatric cohorts with and without benign bilateral vocal fold lesions (BVFL) and to further validate the utility of the pVHI in these patients.

Prospective data collection of pVHI in children with and without BVFL.

Prospective pVHI data was collected from parents of children with and without benign BVFL. Data were examined for four age groups, preschool (3-4), young child (5-8), child (9-12), and adolescent (13-18).

A total of 182 parents filled-out the pVHI; 60 parents of children with no voice disorder and 122 with benign BVFL diagnosed via endoscopy. Among all (n=182), median pVHI subscores in the functional, emotional, and physical domains were significantly increased in BVFL patients compared to non-disordered (all P value <0.001). In patients with BVFL, age showed a direct relationship with emotional pVHI subscore (P < 0.001) but not with physical or functional pVHI subscores (P = 0.4, P = 0.8). There were no differences in talkativeness across groups.

This study demonstrates that children with BVFL across all age groups face negative effects in the functional, physical, and emotional domains compared to those with no lesions. Of interest, the impact of a voice disorder changes as a function of age in children with BVFL. The impact of lesions in adolescents is significantly higher in the emotional domain. These results highlight that the needs of children with a voice disorder may differ at different ages. This information is important for voice professionals, indicating the need to adapt evaluation and therapy strategies accordingly.