Paediatric vocal fold nodules: management strategies to restore normal phonation-Speech-Language Pathologists perspective: A cross-sectional survey.

Mariya Iqbal,Nazia Mumtaz,Ghulam Saqulain,Nayab Iftikhar

doi:10.47391/jpma.4236

Abstract

Vocal fold nodules are benign vocal cord lesions which develop in voice abusers, including children, though chronic cough, sinusitis, and reflux may also be the causative agents. Since low or no-evidence treatment strategies, like the boone technique, are in use in paediatrics, this study was conducted to determine the treatment strategies used by speech-language pathologists in paediatric vocal fold nodules using a cross-sectional survey at Riphah International University, Lahore, from October 2016 to May 2017. Sixty-five speech-language pathologists working with children in private clinics and multidisciplinary settings were recruited using purposive sampling. A self-structured questionnaire was used for data collection. Analysis using SPSS -18 revealed that a combination of voice therapy and vocal hygiene was the most favoured treatment used by 65 (100%) speech-language pathologists, followed by 58 (89.2%) who also favoured respiratory and relaxation exercises, and 56 (86.2%) who also included parental counselling. Hence, a combination of voice therapy and vocal hygiene is a good therapeutic technique being practiced by speech pathologists for the treatment of vocal nodules among paediatric population.

Highlights

Vocal fold nodules (VFN) are non-neoplastic lesions at the junction of anterior and middle third of the vocal folds caused due to trauma associated with vocal abuse and many other conditions, including allergies, post-nasal drip, gastroesophageal reflux, chronic cough, and sinusitis.[1]
Dysphonia in children is common with a prevalence of 6% below the age of 14 years with vocal nodules being the most common cause (22%).[3]
The study revealed that a combination of voice therapy & vocal hygiene was most favoured, agreed upon by all the 65(100%) speechlanguage pathologists (SLPs) and followed by 58(89.2%) who favoured the view that respiratory and relaxation exercises are good; responses revealed significant association with qualification (Table 1)

Summary

Introduction

Vocal fold nodules (VFN) are non-neoplastic lesions at the junction of anterior and middle third of the vocal folds caused due to trauma associated with vocal abuse and many other conditions, including allergies, post-nasal drip, gastroesophageal reflux, chronic cough, and sinusitis.[1]. This study was conducted with the objective to determine the treatment strategies used by speech-language pathologists in paediatric vocal fold nodules. This cross-sectional study, using purposive sampling, recruited a sample of 65 speechlanguage pathologists (SLPs) practicing with paediatric population for at least one year in clinics and multidisciplinary settings with no age and gender limitation. The study revealed that a combination of voice therapy & vocal hygiene was most favoured, agreed upon by all the 65(100%) SLPs and followed by 58(89.2%) who favoured the view that respiratory and relaxation exercises are good; responses revealed significant association with qualification (Table 1). While 52(80%) SLPs agreed that Yawn sign was a direct technique and is the top management option for children with vocal nodules, and SLP’s response showed significant association with qualification

Discussion

Findings

Conclusion