title: Non-invasive assessment of benign vocal folds lesions in children by means of ultrasonography.
abstract: OBJECTIVE
  Flexible fiberoptic endoscopes have made pediatric laryngeal examinations an everyday practice, even though fiberoptic-flexible laryngoscopy (FFL) is not always well tolerated in young children because of limited cooperation. Laryngeal ultrasonography (LUS) has been applied to normal and pathological findings in infants and children, allowing the assessment of subglottic hemangiomas, laryngeal stenosis and paralysis. No previous study assessed benign vocal folds lesions by LUS in children. The aim of this study is to evaluate the possibility of LUS to detect benign vocal fold lesions in children by comparing the results of FFL in 16 children with those of LUS.
  
  
  METHODS
  Sixteen children (9 males and 7 females) with a mean age of 7.5+/-4.0 years were included in the study. Each child underwent FFL performed by a skilled phoniatrician and LUS performed blindly by an expert radiologist.
  
  
  RESULTS
  On FFL bilateral vocal folds nodules were found in 9 patients, vocal fold cyst in 2 other patients, while in 2 children the vocal folds appeared normal. Laryngeal papyllomatosis, vocal fold polyp and vocal fold irregularity were found in only one patient. LUS enabled the diagnosis in all the 14 patients with vocal fold lesions. Bilateral hyperechoic lesions were visible in 10 patients, while hypoechoic lesions were found in three patients. No lesion were found in two children, while one patient presented with a monolateral hyperechoic lesion.
  
  
  CONCLUSIONS
  LUS was accurate, safe, well accepted and tolerated. LUS appears to be a useful diagnostic tool for supplementing FFL in the assessment of benign vocal fold lesions in children and may represent an interesting alternative in everyday clinical practice.
authors.affiliation: Department of Audiology-Phoniatrics, Università degli Studi di Torino, Italy.
authors.forename: M Spadola
authors.initials: MS
authors.lastname: Bisetti
authors.forename: F
authors.initials: F
authors.lastname: Segala
authors.forename: F
authors.initials: F
authors.lastname: Zappia
authors.forename: R
authors.initials: R
authors.lastname: Albera
authors.forename: F
authors.initials: F
authors.lastname: Ottaviani
authors.forename: A
authors.initials: A
authors.lastname: Schindler
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000000981:diagnostic imaging; D008297:Male; D014463:Ultrasonography; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging; D014827:Vocal Cords / Q000000981:diagnostic imaging*