Randomized Controlled Trial of Voice Therapy on Children with Vocal Nodules

描述(由申请人提供)：嗓音障碍使500多万学龄儿童面临学习成绩不佳、社会发展障碍和更多参与犯罪活动的风险。据报道，儿童发声功能障碍最常见的病变是声带小结，它存在于高达21%的普通人群中，并与行为问题和较低的生活质量有关。对于声带小结的治疗，95%的耳鼻咽喉科医生建议使用语音语言病理学家进行嗓音治疗。这种最广泛使用的治疗与儿科嗓音障碍相关的最常见病变的方法尚未在前瞻性对照试验中进行严格测试，以确定它是否真的具有超过相关风险的益处。一项前瞻性临床试验旨在探讨发声疗法是否能改善患有明显声带小结的儿童的发声相关生活质量，这是朝着制定循证治疗计划的方向迈出的合乎逻辑的一步，以优化这一相当大的高危儿童群体的结局。目前还没有强有力的前瞻性对照研究对出现明显结节的儿童进行发声治疗和对照组的比较。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不足。 公共卫生相关性：嗓音障碍使500多万学龄儿童面临学习成绩不佳、社会发展障碍和更多参与犯罪活动的风险。最广泛使用的治疗与儿童嗓音障碍相关的最常见病变的治疗方法尚未在前瞻性对照试验中进行严格测试，以确定它是否真的具有大于相关风险的益处。一项前瞻性临床试验旨在探讨发声疗法是否能改善患有明显声带小结的儿童的发声相关生活质量，这是朝着制定循证治疗计划迈出的合乎逻辑的一步，以优化这一相当大的高危儿童群体的结局。

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.