{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:48:37Z","timestamp":1776134917565,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000098","name":"Clinical Center","doi-asserted-by":"publisher","award":["NIDCD R01DC017923"],"award-info":[{"award-number":["NIDCD R01DC017923"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between lesion size, auditory\u2010perceptual ratings, patient\u2010related quality of life measure, and acoustic voice measures in children with vocal nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirteen children (5\u201310\u2009years) with vocal nodules were recruited in this cross\u2010sectional cohort study. Auditory\u2010perceptual ratings of overall voice severity were performed using a Visual Analog Scale. Acoustic measures of cepstral peak prominence (CPP), low\/high ratio, and the Cepstral Spectral Index of Dysphonia (CSID) were computed on vowels \/a:\/, \/i:\/, and an all\u2010voiced sentence. The Nuss scale was used to rate lesion size from high\u2010speed videoendoscopy (HSV). Patient Voice\u2010Related Quality of Life (PVRQOL) was obtained from both the child and the parent. Correlations were computed for HSV ratings vs. auditory ratings, PVRQOL ratings, and acoustic measures as well as for interrelationships among all variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lesion size on HSV correlated moderately with overall severity of auditory\u2010perceptual voice rating and with acoustic measures CPP and CSID, but not with PVRQOL. Significant, strong correlations were observed between auditory ratings and CPP,\n                      <jats:italic>L<\/jats:italic>\n                      \/\n                      <jats:italic>H<\/jats:italic>\n                      ratio, and CSID in vowels and sentences. Several moderate strength correlations were observed between PVRQOL subscales (parental and child physical function; child social emotional well\u2010being) and acoustic measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Since nodules influence both vocal fold structure and vocal function, multiple parameters (lesion size, auditory\u2010perceptual ratings, measures of physical function and social\u2013emotional impact, and acoustic measurements) are needed to fully characterize the potential effect(s) on the voice. These findings could be used to improve clinical assessment and outcome measurements in children with vocal fold nodules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.32390","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T14:24:17Z","timestamp":1752071057000},"page":"4955-4964","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationship Between Lesion Size, Voice Quality, and Quality of Life in Children With Vocal Nodules"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-5210","authenticated-orcid":false,"given":"Rita R.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Indiana University  Indianapolis Indiana USA"},{"name":"Department of Speech, Language and Hearing Sciences Indiana University  Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-4156","authenticated-orcid":false,"given":"Shaheen N.","family":"Awan","sequence":"additional","affiliation":[{"name":"School of Communication Sciences and Disorders and Communication Technologies Research Center University of Central Florida  Orlando Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maggie","family":"Stall","sequence":"additional","affiliation":[{"name":"Department of Speech, Language and Hearing Sciences Indiana University  Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Seiwert","sequence":"additional","affiliation":[{"name":"Department of Speech, Language and Hearing Sciences Indiana University  Bloomington Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassim","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Delaware  Newark Delaware USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagar","family":"Feinstein","sequence":"additional","affiliation":[{"name":"Private Practice  Ramat Yohana Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Indiana University  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Sowa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Indiana University  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph E.","family":"Dohar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine Verdolini","family":"Abbott","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Delaware  Newark Delaware USA"},{"name":"Department of Linguistics and Cognitive Science University of Delaware  Pittsburgh Pennsylvania 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