目的:本研究旨在阐明小儿嗓音障碍的临床特征。
方法:对1782例嗓音障碍患儿的临床资料进行回顾性分析。这些病例分为四个基于年龄的队列:0-3、4-7、8-11和12-15岁。性别差异等变量,喉镜表现,疾病类型,和声学参数进行了彻底检查。
结果:本研究共纳入1782名声嘶哑儿童,包括1325名男性和457名女性。当比较各组儿童的性别比例时,发现男性数量超过女性。在所有年龄组中都观察到明显的男性优势。喉镜检查结果显示,最普遍的情况是声带结节(1363例,76.48%),其次是声带息肉(271例,15.20%)。其他疾病包括喉乳头状瘤,声带运动障碍,声带囊肿,功能性发声障碍,声带白斑,以及喉淀粉样变性和声门下颗粒细胞瘤等喉良性肿瘤。其中,382名儿童(21.44%)出现腺样体肥大。此外,进行了反流发现评分(RFS),799例(44.83%)得分在7分以上。各种疾病在不同年龄段的分布表明,儿童声带小结(637例,46.74%),声带息肉(109例,40.22%),喉乳头状瘤(35,36.84%)主要发生在4-7岁年龄段。小儿急性喉炎(3例,75%)和声带运动障碍(8例,36.36%)在0-3岁年龄组中更为常见。功能性发音障碍(4例,66.67%)和声带白斑(4例,80%)主要在12-15岁年龄段观察到,而声带囊肿主要见于8-11岁年龄组(4例,57.14%)。对153名儿童的声学参数进行比较分析,发现抖动差异有统计学意义,基频(F0),语音障碍指数(VHI),反流症状指数(RSI),和不同病理的RFS。
结论:这项研究强调了声带小结,声带息肉,喉乳头状瘤是小儿声音嘶哑的主要原因,尽管不能忽视肿瘤和罕见疾病的可能性。对男性有明显的性别偏见,功能性发音障碍在年龄较大的儿童中更为普遍。
OBJECTIVE: This study aims to clarify the clinical characteristics of pediatric voice disorders.
METHODS: The clinical data of 1782 pediatric patients presenting with voice disorders were retrospectively analyzed. These cases were categorized into four age-based cohorts: 0-3, 4-7, 8-11, and 12-15years. Variables such as gender disparities, laryngoscopic manifestation, disease types, and acoustic parameters were thoroughly examined.
RESULTS: A total of 1782 children with acoustic hoarseness were included in this study, comprising 1325 males and 457 females. When the sex ratio among the children in each group was compared, males were found to outnumber females. A notable male predominance was observed across all age groups. Laryngoscopic results revealed that the most prevalent condition was vocal cord nodules (1363 cases, 76.48%), followed by vocal cord polyps (271 cases, 15.20%). Other diseases included laryngeal papillomas, vocal fold movement impairment, vocal cord cysts, functional
dysphonia, leukoplakia of the vocal cords, and benign laryngeal tumors such as laryngeal amyloidosis and subglottic granular cell tumors. Among these, adenoid hypertrophy was presented in 382 children (21.44%). Additionally, the Reflux Finding Score (RFS) was conducted, and 799 cases (44.83%) were found to have a score above 7. The distribution of various diseases across different age groups indicated that children with vocal cord nodules (637 cases, 46.74%), vocal cord polyps (109 cases, 40.22%), and laryngeal papillomas (35, 36.84%) were predominantly found in the 4-7 years age group. Pediatric acute laryngitis (three cases, 75%) and vocal fold movement impairment (eight cases, 36.36%) were more common in the 0-3 years age group. Functional
dysphonia (four cases, 66.67%) and vocal cord leukoplakia (four cases, 80%) were mainly observed in the 12-15 years age group, while vocal cord cysts were predominantly seen in the 8-11 years age group (four cases, 57.14%). A comparative analysis of acoustic parameters among 153 children showed statistically significant differences in jitter, fundamental frequency (F0), voice handicap index (VHI), reflux symptom index (RSI), and RFS across different pathologies.
CONCLUSIONS: This study highlighted that vocal cord nodules, vocal cord polyps, and laryngeal papillomas were the primary causes of pediatric hoarseness, although the possibility of tumors and rare diseases cannot be disregarded. There was a noticeable gender bias towards males, and functional
dysphonia was significantly more prevalent in older children.