Pediatric patients with vocal nodules voice quality evalaution of the acoustic voice analysis and pediatric voice handi?cap index

Vocal cordnodules are one of the most common cause of hoarseness in children. Nodules cause deterioration in voice with blocking the fully closure of the glottis during fonation. Nodules occur in the place where vibration aplitudes are mostly higher in vocal cords. Because of the difficulty in the assessment of larynx with noninvasive methods in pediatric group, it is important to assess the acoustic characteristics of the voice by using objective and subjective methods. This study include 35 subjects with the diagnosis of vocal cord nodule as study group and 34 children as control group between the ages of 6 and 12 years. The subjects were done voice analysis assessment by using MDVP andMaximum PhonationTime (MPT)and s/z duration were measured as aerodinamic assessment. Parents were required to fill out the Pediatric Voice Handicap Index (PVHI) to identify the social, emotional, functional etc. effects of voice deterioration on children. The significant differenece were found in MDVP datas, MPTand s/z ratio between subjects in study and control group in our study (p<0.05). S/Z ratio were increased while MPT value were shortened in the group with vocal cord nodule. The existence of vocal cord nodule effect the voice quality negatively. It was observed that the study group scores were significantly higher in all parts of PVHI in our study. It was concluded that vioce disorder has negative effects on emotional, psychological and social aspects on patients. The significant difference were found in the subparameters of PVHI as speaking frequency and vioce intensity scores between groups (p<0.05). Vocal cord nodules were found to occur mostly in male children with higher and excessive intensity of speaking tendency. After the assessment of correlation between voice analysis parameters and PVHI results in study group; positive correlations were found between Fo value and functional part, Shimmer value and emotional part, ShdB value and functional, emotional parts and totalscore of questionnaire (p<0.05). It was thought 67that voice analysis, aerodynamic assessment and PVHI results are helpfull in diagnosis and follow up of children with dysphonia. Key WordsVocal Nodule, Voice Analysis, Pediatric Voice Handicap Index, VoiceQuality