Nuss Roger C, Ward Jessica, Huang Lin, Volk Mark, Woodnorth Geralyn Harvey
Dept of Otolaryngology and Communication Enhancement, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
Ann Otol Rhinol Laryngol. 2010 Oct;119(10):651-5. doi: 10.1177/000348941011901001.
We examined the relationship between the size of vocal fold nodules and perceptual rating of voice quality in children.
We carried out an Institutional Review Board-approved retrospective study in a voice clinic within a tertiary-care pediatric medical center. We studied children seen between 2000 and 2009 with a primary diagnosis of vocal fold nodules as the cause of their voice disturbance. Pediatric vocal fold nodule size was rated with a published validated scale, and voice quality was rated on the Consensus Auditory-Perceptual Evaluation of Voice scale.
One hundred forty-five patients met the inclusion criteria. Small nodules were noted in 23% of patients, medium nodules in 39%, and large nodules in 37%. Univariate and multivariate analyses demonstrated a statistically significant relationship (p < 0.05) between vocal fold nodule size and rated perceptual qualities of overall severity of voice disturbance, roughness, strain, pitch, and loudness. With the exception of loudness, as vocal fold nodule size increased, the mean value of perceptual characteristics became larger. The age of the patient was a significant factor associated with the overall severity of the voice disturbance and roughness.
The overall severity of a child's voice disturbance and qualities of roughness, strain, pitch, and loudness have a strong correlational relationship with pediatric vocal fold nodule size, which is suggestive of causality.
我们研究了儿童声带小结大小与嗓音质量的感知评分之间的关系。
我们在一家三级儿科医疗中心的嗓音诊所进行了一项经机构审查委员会批准的回顾性研究。我们研究了2000年至2009年间因嗓音障碍而初诊为声带小结的儿童。儿科声带小结大小采用已发表的有效量表进行评定，嗓音质量采用嗓音共识听觉-感知评估量表进行评定。
145例患者符合纳入标准。23%的患者有小结节，39%有中等结节，37%有大结节。单因素和多因素分析表明，声带小结大小与嗓音障碍总体严重程度、粗糙度、紧张度、音高和响度的感知质量之间存在统计学显著关系（p < 0.05）。除响度外，随着声带小结大小增加，感知特征的平均值变大。患者年龄是与嗓音障碍总体严重程度和粗糙度相关的一个重要因素。
儿童嗓音障碍的总体严重程度以及粗糙度、紧张度、音高和响度质量与儿科声带小结大小有很强的相关性，这提示存在因果关系。
