Vocal Fold Nodules Clinical Trial
Official title:
Randomized Controlled Trial of Voice on Children With Vocal Nodules
The primary objective of this study is to determine the impact of voice therapy on voice-related quality of life in children age 6-10 years old with apparent vocal fold nodules, as measured by the validated Pediatric Voice-Related Quality of Life Instrument (PVRQOL)administered 4 weeks after completion of voice therapy.
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 pediatric
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. When implemented, this voice therapy requires significant
time investment and typically results in regular absence from the classroom over a period of
1-3 months or longer, depending on the protocol and the setting. Regular absence from school
has been shown to place children at risk for poorer scholastic performance but the benefits
of this voice therapy have yet to be demonstrated in any rigorous prospective, controlled
trial. Thus, the most widely used treatment for the most common lesion associated with
pediatric voice disorders has not been rigorously tested in a randomized controlled trial to
determine whether it may have benefits.
A randomized 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. 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 testing of the following primary null hypothesis: There is no
difference in the change in PVRQOL scores after 3 months of treatment with voice therapy
versus office instructions.
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Observational Model: Cohort, Time Perspective: Prospective
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