Randomized Controlled Trial of Voice Therapy on Children with Vocal Nodules

描述（由申请人提供）：语音障碍使500多万学龄儿童面临学习成绩差、社会发展障碍和更多参与犯罪活动的风险增加。据报道，与儿童声带功能障碍最相关的病变是声带结节，在总人口中高达21%的人群中存在，并与行为问题和生活质量低下有关。95%的耳鼻喉科医生推荐由语言病理学家进行语音治疗来治疗声带结节。这种最广泛使用的治疗与儿童声音障碍相关的最常见病变的方法尚未经过前瞻性对照试验的严格测试，以确定它是否真的有超过相关风险的益处。一项前瞻性临床试验旨在探讨语音治疗是否能改善明显声带结节儿童的语音相关生活质量，这是为这一庞大的高危儿童群体制定循证治疗计划以优化结果的合乎逻辑的一步。目前还没有强有力的、前瞻性的、对照的研究来比较声音疗法和对照组对患有明显结节的儿童的影响。我们的目标是通过以下拨款提案中概述的随机、安慰剂对照研究来弥补这一缺陷。

DESCRIPTION (provided by applicant): Voice disorders place over five million school-aged children at increased risk for inferior school performance, dysfunctional social development, and higher participation in criminal activities. The lesions most commonly associated with pediatric vocal dysfunction are reported to be vocal fold nodules, which are present in up to 21% of the general population, and are associated with behavioral problems and inferior quality of life. Voice therapy with a speech-language pathologist is recommended by 95% of otolaryngologists for management of vocal fold nodules. This most widely used treatment for the most common lesion associated with pediatric voice disorders has not been rigorously tested in prospective controlled trials to determine whether it truly has benefits that outweigh the associated risks. A prospective clinical trial addressing whether voice therapy improve voice-related quality of life for children with apparent vocal fold nodules is a logical step toward developing an evidence-based treatment plan to optimize outcomes for this sizable population of at-risk children. There are currently no well-powered, prospective, controlled studies which compare voice therapy versus control in children who present with apparent nodules. Our goal is to remedy this deficiency through the randomized, placebo controlled study outlined in the following grant proposal. PUBLIC HEALTH RELEVANCE: Voice disorders place over five million school-aged children at increased risk for inferior school performance, dysfunctional social development, and higher participation in criminal activities. The most widely used treatment for the most common lesion associated with pediatric voice disorders has not been rigorously tested in prospective controlled trials to determine whether it truly has benefits that outweigh the associated risks. A prospective clinical trial addressing whether voice therapy improves voice-related quality of life for children with apparent vocal fold nodules is a logical step toward developing an evidence-based treatment plan to optimize outcomes for this sizable population of at-risk children.