Song Brian H, Merchant Maqdooda, Schloegel Luke
1 Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.
2 Division of Research, Kaiser Permanente, Oakland, California, USA.
Otolaryngol Head Neck Surg. 2017 Nov;157(5):824-829. doi: 10.1177/0194599817726285. Epub 2017 Aug 22.
Objective To evaluate the voice outcomes of adults diagnosed with vocal fold nodules (VFNs) as children and to assess the impact of speech therapy on long-term voice outcomes. Study Design Prospective cohort study. Setting Large health care system. Subjects and Methods Subjects diagnosed with VFNs as children between the years 1996 and 2008 were identified within a medical record database of a large health care system. Included subjects were 3 to 12 years old at the time of diagnosis, had a documented laryngeal examination within 90 days of diagnosis, and were ≥18 years as of December 31, 2014. Qualified subjects were contacted by telephone and administered the Vocal Handicap Index-10 (VHI-10) and a 15-item questionnaire inquiring for confounding factors. Results A total of 155 subjects were included, with a mean age of 21.4 years (range, 18-29). The male:female ratio was 2.3:1. Mean VHI-10 score for the entire cohort was 5.4. Mean VHI-10 scores did not differ between those who received speech therapy (6.1) and those who did not (4.5; P = .08). Both groups were similar with respect to confounding risk factors that can contribute to dysphonia, although the no-therapy group had a disproportionately higher number of subjects who consumed >10 alcoholic drinks per week ( P = .01). Conclusion The majority of adults with VFNs as children will achieve a close-to-normal voice quality when they reach adulthood. In our cohort, speech therapy did not appear to have an impact on the long-term voice outcomes.
目的 评估儿童期被诊断为声带小结（VFNs）的成年人的嗓音结局，并评估言语治疗对长期嗓音结局的影响。研究设计 前瞻性队列研究。研究地点 大型医疗保健系统。对象与方法 在一个大型医疗保健系统的病历数据库中，识别出1996年至2008年间儿童期被诊断为VFNs的对象。纳入对象在诊断时年龄为3至12岁，在诊断后90天内有喉镜检查记录，截至2014年12月31日年满18岁。通过电话联系合格对象，让他们填写嗓音障碍指数-10（VHI-10）和一份询问混杂因素的15项问卷。结果 共纳入155名对象，平均年龄21.4岁（范围18 - 29岁）。男女比例为2.3:1。整个队列的平均VHI-10评分为5.4。接受言语治疗者的平均VHI-10评分（6.1）与未接受言语治疗者（4.5；P = 0.08）无差异。两组在可能导致发音障碍的混杂风险因素方面相似，尽管未接受治疗组每周饮用超过10杯酒精饮料的对象比例过高（P = 0.01）。结论 大多数儿童期患有VFNs的成年人成年后嗓音质量接近正常。在我们的队列中，言语治疗似乎对长期嗓音结局没有影响。
