Voice Therapy for Pediatric Vocal Fold Nodules

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  • Maekawa Keiko
    Department of Otolaryngology, Kobe City Hospital Organization Kobe City Medical Center General Hospital

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Other Title
  • 小児声帯結節に対する音声治療

Abstract

<p>Vocal fold nodules (VFNs) are the most frequent cause of voice problems in children and are caused mainly by vocal abuse and misuse. In adults, voice therapy is used as a first-line therapy. In contrast, many Japanese hospitals and clinics do not promote the use of voice therapy in children, because natural remission is expected in most pediatric VFN cases and it is thought children are not unduly bothered by dysphonia. However, children with severe hoarseness and girls with allergic diseases are likely to have voice complaints that remain after they reach puberty. Moreover, it has been reported that children, like adults, are aware of their dysphonia, and that people with this problem are disadvantaged socially. In light of these issues, voice therapy should be provided for pediatric VFNs, at least in those children who are at high risk of a poor prognosis. <br>In our clinic, we provide voice therapy for VFNs in children accompanied by their parent(s) or guardian(s). In our vocal hygiene instruction, we do not prohibit vocalizations other than shouting, but we instruct the children to be aware of vocal misuse themselves and to correct their bad phonation habits. Voice training is performed by using semi-occluded vocal tract exercises. In the past 10 years, reports on the effectiveness of voice therapy in children with VFNs have been increasing, but many of these studies have not been well designed. Further consideration needs to be given to this point.</p>

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