Rahul K Shah1, Samuel H Engel, Sukgi S Choi. 1. Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA. rshah@cnmc.org
Abstract
OBJECTIVE: To determine the effect of vocal nodule size on voice in pediatric patients. STUDY DESIGN: Vocal nodules were graded according to a validated grading scale by three pediatric otolaryngologists. SUBJECTS AND METHODS: Patients evaluated from 2003 to 2007 with a diagnosis of vocal nodules were included. RESULTS: Forty patients (21 female) with a mean age of 7.5 years were identified. Vocal nodules were rated as grade 1 (17 patients), grade 2 (15 patients), and grade 3 (8 patients). Pitch range was reduced in patients with larger nodules (P = 0.001). There was no statistical association between nodule grade and fundamental frequency abnormality, perturbation, shimmer, decreased respiratory support, air loss, or significant muscle tension. CONCLUSIONS: Voice characteristics in patients with vocal nodules were evaluated. Other than pitch reduction, objective and subjective voice measurements are not statistically different in varying vocal nodule sizes; however, many of the measures did show a trend towards significance. Vocal rehabilitation is complex in children with nodules and may not directly correlate with vocal nodule size.
OBJECTIVE: To determine the effect of vocal nodule size on voice in pediatric patients. STUDY DESIGN: Vocal nodules were graded according to a validated grading scale by three pediatric otolaryngologists. SUBJECTS AND METHODS: Patients evaluated from 2003 to 2007 with a diagnosis of vocal nodules were included. RESULTS: Forty patients (21 female) with a mean age of 7.5 years were identified. Vocal nodules were rated as grade 1 (17 patients), grade 2 (15 patients), and grade 3 (8 patients). Pitch range was reduced in patients with larger nodules (P = 0.001). There was no statistical association between nodule grade and fundamental frequency abnormality, perturbation, shimmer, decreased respiratory support, air loss, or significant muscle tension. CONCLUSIONS: Voice characteristics in patients with vocal nodules were evaluated. Other than pitch reduction, objective and subjective voice measurements are not statistically different in varying vocal nodule sizes; however, many of the measures did show a trend towards significance. Vocal rehabilitation is complex in children with nodules and may not directly correlate with vocal nodule size.