title: Laryngeal ultrasound and pediatric vocal fold nodules.
abstract: The term vocal fold nodules refers to bilateral thickening of the membranous folds with minimal impairment of the vibratory properties of the mucosa. Nodules are thought to be related to repetitive mechanical stress, associated with voice use patterns. Diagnosis is typically made in the office via either rigid or flexible laryngeal stroboscopy. Depending on the individual child, obtaining an optimal view of the larynx can be difficult if not impossible. Recent advances in high-frequency ultrasonography allows for transcervical examination of laryngeal structures. The goal of this project was to determine if laryngeal ultrasound (LUS) can be used to identify vocal fold nodules in dysphonic children.
  
  
  
  Prospective case-control study in which the patient acted as his or her own control.
  
  
  
  Forty-six pediatric patients were recruited for participation in this study; the mean age was 4.8 years. Twenty-three did not have any vocal fold lesions and 23 had a diagnosis of vocal fold nodules on laryngeal stroboscopy. Recorded LUSs were reviewed by two pediatric radiologists who were blinded to the nodule status.
  
  
  
  There was substantial inter-rater agreement (κ = 0.70, 95% confidence interval [CI]: 0.50-0.89) between the two radiologists regarding the presence of nodules. There was also substantial agreement (κ = 0.87, 95% CI: 0.72-1) between LUS and laryngeal stroboscopy. Sensitivity of LUS was 100% (95% CI: 85%-100%) and specificity was 87% (95% CI: 66%-97%).
  
  
  
  LUS can be used to identify vocal fold nodules in children with substantial agreement with laryngeal stroboscopy.
  
  
  
  3b Laryngoscope, 127:676-678, 2017.
authors: Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas.
authors: Julina
authors: J
authors: Ongkasuwan
authors: Department of Speech Pathology, Texas Children's Hospital, Houston, Texas.
authors: Danielle
authors: D
authors: Devore
authors: Department of Speech Pathology, Texas Children's Hospital, Houston, Texas.
authors: Sarah
authors: S
authors: Hollas
authors: Department of Pediatric Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, U.S.A.
authors: Jeremy
authors: J
authors: Jones
authors: Department of Pediatric Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, U.S.A.
authors: Brandon
authors: B
authors: Tran
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D012016:Reference Values; D049489:Stroboscopy / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods*; D014827:Vocal Cords / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Pediatric airway; dysphonia; laryngeal ultrasound; vocal fold nodules; voice