title: Vocal fold nodules in children: preferable therapy.
abstract: BACKGROUND
  The purpose of this paper is to know the preferable treatment for vocal fold nodules in children.
  
  
  METHODS
  Two hundred and fifty nine patients with vocal fold nodules (176 males and 83 females) were retrospectively reviewed. Age ranged from 2 to 18 years with a mean age of 9 years. In addition, questionnaire survey was carried out, asking about their present voice.
  
  
  RESULTS
  Sixteen percent of the patients showed improvement by vocal hygiene advice. Fifty two percent of patients receiving voice therapy showed some improvement. Eighty nine percent of patients showed some improvement by endolaryngeal microsurgery. With respect to the influence of puberty upon the voice, there was no significant difference among vocal hygiene, voice therapy, and no-treatment for pre-puberty cases. Surgical treatment was the only reliable method to acquire voice improvement for pre-puberty cases. In contrast, following puberty there was no significant difference in voice improvement among treatment modalities.
  
  
  CONCLUSIONS
  If the patient needs immediate improvement of voice, surgery is preferable. If they need the improvement of voice but do not hurry up, voice therapy should be carried out. If patients have no motivation, vocal hygiene is recommended.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kurume University School of Medicine, Japan. kazuyoko@hf.rim.or.jp
authors.forename: K
authors.initials: K
authors.lastname: Mori
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000601:surgery / Q000628:therapy; D008297:Male; D014827:Vocal Cords / Q000473:pathology; D014832:Voice Disorders / Q000209:etiology / Q000628:therapy*; D014833:Voice Quality