Pediatric Dysphonia: A Cross-Sectional Survey of Subspecialty and Primary Care Clinics

Johnson, Christopher M.; Anderson, Danielle C.; Brigger, Matthew T.

doi:10.1016/j.jvoice.2018.08.017

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…Our results of acoustic analysis for children from the control group accord with results from other researchers [20,21]. Moreover, the results for Polish children with dysphonia showed similar trends to those described in the literature for pediatric populations of other nationalities [22,23]. The children with dysphonia had significantly higher parameter values than those of healthy children, especially for parameters describing frequency and amplitude disturbances and parameters describing the presence of noise components.…”

Section: Discussionsupporting

confidence: 89%

Voice quality in Polish children with vocal fold nodules

Szkiełkowska¹,

Krasnodębska²,

Myszel³

2023

J Hear Sci

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BackgroundVocal fold nodules are a common cause of pediatric dysphonia. The aim of the study was to assess the acoustic structure of the voice in children with vocal fold nodules and investigate the relationship between objective and subjective measures.Material and methodsThe study group consisted of 223 children, aged 7 to 12 years with normal hearing. The control group included 213 children. All children underwent ENT and phoniatric examination including laryngovideostroboscopy (LVS), assessment of voice on the GRBAS perceptual scale, and acoustic analysis (spectrographic analysis using the Multi-Dimensional Voice Profile).ResultsIn children with vocal fold nodules the average perceptual score for their voice was G1R1B0A0S2. No statistically significant effect of the child’s sex or age on the values of the MDVP parameters was found. The acoustic structure of the voice of children with childhood dysphonia and vocal fold nodules differed significantly from the acoustic structure of those in the control group. A relationship between GRBAS features and MDVP analysis was found.ConclusionsVoice acoustic analysis is a valuable tool for assessing voice quality in children. The analysis can identify deviations from normal values that the human ear is unable to pick up.

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Section: Discussionsupporting

confidence: 89%

Voice quality in Polish children with vocal fold nodules

Szkiełkowska¹,

Krasnodębska²,

Myszel³

2023

J Hear Sci

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“…The reported prevalence of voice disorders in the pediatric population varies widely between studies, ranging from 3.9% to 23%. [1][2][3][4] The most common cause of dysphonia in children is widely believed to be vocal fold nodules, 4 though dysphonia may arise from a variety of iatrogenic, idiopathic, neurological, and functional causes. While dysphonia in children is often caused by benign conditions (e.g., vocal fold lesions like nodules, polyps, cysts), 5 it may also be a presenting symptom of a more severe or progressive illness requiring prompt diagnosis and management.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Dysphonia: When to Refer

Hseu

Spencer

et al. 2023

Clin Pediatr (Phila)

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The reported prevalence of voice disorders in the pediatric population varies widely between studies, ranging from 3.9% to 23%. Despite this, not all children with dysphonia are referred to a voice specialist for further evaluation. The objective of this study is to examine the relationship between dysphonia history, voice assessment, and laryngeal findings to help guide referrals of dysphonic children. A retrospective review was conducted of pediatric patients at a tertiary voice clinic between January 2014 and December 2017. Data including dates of presentation, demographics, co-morbidities, presenting symptoms, laryngeal exam findings, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores, and Pediatric Voice Handicap Index (pVHI) scores were collected and analyzed. Of 475 patients initially identified, 459 met inclusion criteria and were reviewed. In all, 272 (59.3%) were male and 187 (40.7%) were female. Mean age at first presentation was 8.6 years old (range: 2-18). Males were more likely to present at a younger age than females. CAPE-V data were available for 439 patients, and pVHI data were available for 109 patients. The mean CAPE-V Overall Severity score was 38.2. The mean total pVHI score was 25.4. Males had higher CAPE-V Overall Severity (40.0 vs. 35.4), Roughness (32.2 vs. 27.6), and Strain scores (37.2 vs. 32.4) than females. Patient pVHI scores did not differ by gender. In all, 283 patients self-reported a length of symptoms prior to evaluation. Children with a longer duration of symptoms prior to evaluation had higher CAPE-V Overall Severity scores. Diagnoses of vocal fold movement impairment and benign vocal fold lesions that were not nodules were associated with higher average CAPE-V Overall Severity scores. Overall, 310 patients (67.5%) were recommended intervention for their dysphonia. These patients had higher CAPE-V Overall Severity scores than those who were solely recommended observation (42.8 vs. 28.0). Males were more likely than females to present with dysphonia and presented with more severe perceptual dysphonia scores on average. The length of symptoms and certain diagnoses correlated with higher CAPE-V Scores. Referrals to a pediatric voice clinic should be considered in patients with a dysphonia history lasting greater than 3 months and in patients with more severe symptoms.

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“…Voice disorders impede communication and adversely affect the quality of life for many children 1 . The prevalence of pediatric dysphonia is unknown but has been estimated to be somewhere between 1.4% and 23.9% 2–7 . These numbers likely underestimate the true prevalence of laryngeal pathology as many voice problems in children go unreported 7 .…”

Section: Introductionmentioning

confidence: 99%

“…1 The prevalence of pediatric dysphonia is unknown but has been estimated to be somewhere between 1.4% and 23.9%. [2][3][4][5][6][7] These numbers likely underestimate the true prevalence of laryngeal pathology as many voice problems in children go unreported. 7 Pediatric voice disorders often have negative emotional and social ramifications, 8 as dysphonia can impact the way children are perceived by their peers 9 and teachers.…”

Section: Introductionmentioning

confidence: 99%

Voice Therapy Improves Acoustic and Auditory‐Perceptual Outcomes in Children

2022

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This study employed acoustic measures as well as auditory-perceptual assessments to examine the effects of voice therapy in children presenting with benign vocal fold lesions.Methods: A retrospective, observational cohort design was employed. Sustained vowels produced by 129 children diagnosed with benign vocal fold lesions were analyzed, as well as connected speech samples produced by 47 children. Treatment outcome measures included Consensus of Auditory-Perceptual Evaluation of Voice (CAPE-V), jitter, shimmer, Noise-to-Harmonic Ratio (NHR), cepstral peak prominence (CPP), and Low-to-High Ratio (LHR) on sustained vowels, and CPP and LHR on connected speech.Results: Following voice therapy, significant improvements in CAPE-V ratings (p < 0.001) were observed. Additionally, jitter (p = 0.041), NHR (p = 0.019), and CPP (p < 0.01) on sustained vowels, and CPP (p = 0.002), and LHR (p = 0.008) on connected speech significantly improved following voice therapy. CPP increased with age in males but did not change in females. CAPE-V ratings and perturbation measures indicated that dysphonia was more severe in younger children pre and posttherapy.Conclusions: Auditory-perceptual and acoustic measures demonstrated improved voice quality following voice therapy in children with dysphonia. CPP effectively quantified voice therapy gains and allowed for analysis of connected speech, in addition to sustained vowels. These findings demonstrate the value of CPP as a tool in assessing therapy outcomes and support the efficacy of voice therapy for children presenting with vocal fold lesions.

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Pediatric Dysphonia: A Cross-Sectional Survey of Subspecialty and Primary Care Clinics

Cited by 15 publications

References 14 publications

Voice quality in Polish children with vocal fold nodules

Voice quality in Polish children with vocal fold nodules

Pediatric Dysphonia: When to Refer

Voice Therapy Improves Acoustic and Auditory‐Perceptual Outcomes in Children

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