Evolution of vocal fold nodules from childhood to adolescence.

SUMMARY: Bilateral (quasi) symmetrical lesions of the anterior third of the vocal folds, commonly called vocal fold nodules (VFNs) are the most frequent vocal fold lesions in childhood caused by vocal abuse and hyperfunction. This study evaluates their long-term genesis with or without surgery and voice therapy. A group of 91 postmutational adolescents (mean age, 16 years), in whom VFNs were diagnosed in childhood, were questioned to analyze the evolution of their complaints. Thirty four of them could be clinically reexamined by means of the European Laryngological Society-protocol, including a complete laryngological investigation and voice assessment. A total of 21% of the questioned group (n=91) had voice complaints persisting into postpubescence with a statistically significant difference (P

Evaluation of the vocal performance of children using a voice range profile index.

Voice range profiles (VRPs) were analyzed according to 11 frequency, intensity, and morphological characteristics for 94 normal children and 136 children with vocal fold pathologies (ages 6-11 years). Normative data are presented showing marked differences between the groups. Using a specific combination of the child's age, the highest vocal fundamental frequency, the lowest intensity, and the slope of the upper VRP contour, a Voice Range Profile Index for Children (VRPIc) may be constructed using discriminant analysis. It is shown how the VRPIc can be used to screen children for vocal disorder or to quantitatively assess the effectiveness of voice treatment. Since the group means of the VRPIc for healthy and dysphonic children are scaled to +10 and -10, respectively, the VRPIc enables the clinician to rate a child's vocal performance with reference to healthy and dysphonic children in general. The sensitivity and specificity of this method was found to be 90% and 83%, respectively.

Phonetography in voice diagnoses.

Phonetography has been defined by SCHUTTE and SEIDNER in 1983. Nevertheless publications on phonetography go back to the thirties. Due to publications in the last decade and the development of computer phonetography this testing method has been used for various purposes in voice evaluation. This article gives a historical background, with the different ways of phonetogram recording and describes variables who have their effect on phonetogram results and interpretation. Secondly the range of application with normative and reference phonetograms is discussed.

The comparison of different calculation formulas for the interpretation of the pure-tone audiometry in the evaluation of professional hearing-loss.

The authors report the analysis of 761 cases of auditive impairment, of which 676 are due to professional noise exposure. They compare the different interpretation formulas of the pure-tone audiometry (Fletcher-Fournier-Fund of Occupational Diseases (FOD) the one to the other by means of regression analyses. Moreover, different cut-off values are discussed on the basis of their sensibility, specificity and validity in comparison with the subjective repercussion of the impairment on the social relations of the individual. The authors demonstrate the advantage of the use of the FOD formula for the evaluation of subjective hearing loss. For the professional hearing loss the limits of 50 or 55 dB FOD give the highest validity. For the hearing loss of non professional origin the highest validity is obtained with the cut-off value of 60 dB FOD corresponding to 50 dB Fletcher or Fournier. The differences between the latter two formulas are unsignificant.