Al-Kadi Mohammad, Alfawaz Mohamed A, Alotaibi Fahad Z
Otolaryngology - Head & Neck Surgery, King Abdulaziz Medical City, Riyadh, SAU.
Otolaryngology - Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
Cureus. 2022 Apr 24;14(4):e24433. doi: 10.7759/cureus.24433. eCollection 2022 Apr.
One of the most prevalent pediatric ailments around the world is voice disorders. Around 5-million children suffer from voice disorders, and three out of five of them suffer from vocal nodule-induced persistent dysphonia. Nineteen out of 20 otolaryngologists recommend voice therapies for the treatment of pediatric vocal fold nodules. However, the benefits of these therapies still remain to be assessed systematically. The objective of this study is to systematically review the impact of voice therapy (direct and indirect) on pediatric patients with vocal nodules. In this systematic review of randomized control trials (RCTs), four electronic databases, PubMed, CENTRAL (Cochrane), Science Direct, and Lancet, were explored for the literature survey. The impact of direct and indirect voice therapies on pediatric cases with vocal nodules was reviewed based on the results of the selected articles. Based on stringent inclusion and exclusion criteria, six articles were selected. All these studies examined the effects of direct and indirect voice therapies on two types of voice disorders, that is, dysphonia and vocal nodules. Only one of the six studies reported significant alleviation of the patient condition post-intervention. However, none of the studies discussed the clinical significance of the interventions. Three of the six included studies used both direct and indirect voice therapies and reported substantial differences in the data collected before and after the interventions. However, overall, the studies reported more significant improvements in patient conditions. More studies in this domain are still warranted, especially to help understand and define the meaning of the term "effectiveness" with respect to voice therapies.
声音障碍是全球最常见的儿科疾病之一。全球约有500万儿童患有声音障碍，其中五分之三患有声带小结引起的持续性发音困难。每20名耳鼻喉科医生中有19名推荐采用嗓音治疗来治疗小儿声带小结。然而，这些治疗方法的益处仍有待系统评估。本研究的目的是系统回顾嗓音治疗（直接和间接）对小儿声带小结患者的影响。在这项对随机对照试验（RCT）的系统评价中，我们检索了四个电子数据库，即PubMed、CENTRAL（Cochrane）、Science Direct和《柳叶刀》，以进行文献调查。根据所选文章的结果，回顾了直接和间接嗓音治疗对小儿声带小结病例的影响。基于严格的纳入和排除标准，我们选择了6篇文章。所有这些研究都考察了直接和间接嗓音治疗对两种声音障碍的影响，即发音困难和声带小结。六项研究中只有一项报告干预后患者病情有显著缓解。然而，没有一项研究讨论了干预措施的临床意义。六项纳入研究中有三项同时使用了直接和间接嗓音治疗，并报告了干预前后收集的数据存在显著差异。然而，总体而言，这些研究报告患者病情有更显著的改善。该领域仍需要更多的研究，特别是有助于理解和界定“有效性”一词在嗓音治疗方面的含义。
