Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Department, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Department, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
J Voice. 2019 Jul;33(4):561-563. doi: 10.1016/j.jvoice.2017.12.017. Epub 2018 Sep 14.
Vocal nodules are frequent in children and tend to be reabsorbed after puberty, especially in boys. The aims of the present study were to analyze the progression of nodules in boys after puberty and to investigate the role of microweb in the persistence of these lesions.
Clinical and videolaryngoscopy evaluations were carried out in boys with vocal nodules treated between 2009 and 2016, followed up to the age of 17 years or until remission of symptoms and reabsorption of the nodules. Boys with vocal nodules who underwent regular vocal therapy are included in the study. The outcomes were remission of symptoms and of the nodular lesions.
A total of 34 boys with vocal nodules were diagnosed, of which 21 completed follow-up. Mean age of the first evaluation was 9 years (5-11 years) and of end of treatment was 14 years (13-18 years). Mean number of videolaryngoscopy per child was five. After adolescence there was complete remission of symptoms and of the lesions in 15 children (71.4%), partial remission in four (19.0%), and no remission of symptoms and of the lesions in two cases. In these two, videolaryngoscopy identified the presence of microweb and nodules.
Favorable reabsorption of the vocal nodules after adolescence was observed in the majority of the boys who underwent voice therapy; however, in two cases there was no remission of symptoms and of the lesions. The unfavorable course can be attributed to anterior laryngeal microwebs.
儿童中声带小结较为常见，且往往在青春期后可自行吸收，尤其在男孩中更为明显。本研究旨在分析青春期后男孩声带小结的进展情况，并探讨微小结的存在对这些病变持续存在的影响。
对 2009 年至 2016 年间接受治疗的患有声带小结的男孩进行临床和频闪喉镜评估，随访至 17 岁或直至症状缓解和小结吸收。研究纳入接受常规嗓音治疗的患有声带小结的男孩。主要结局为症状和小结病变的缓解。
共诊断出 34 名患有声带小结的男孩，其中 21 名完成了随访。首次评估的平均年龄为 9 岁（5-11 岁），治疗结束时的平均年龄为 14 岁（13-18 岁）。每个孩子的频闪喉镜检查平均次数为 5 次。青春期后，15 名儿童（71.4%）症状和病变完全缓解，4 名儿童（19.0%）部分缓解，2 名儿童症状和病变无缓解。在这 2 名儿童中，频闪喉镜检查发现存在微小结和小结。
大多数接受嗓音治疗的男孩在青春期后声带小结可自行吸收，但有 2 名儿童症状和病变无缓解。病情无缓解可能与喉前部微小结有关。
