KRISTEN PYTYNIA, MD
MILWAUKEE, WISCONSIN

Vocal cord nodules in children usually resolve regardless of treatment. We present prospective long-term follow-up on children treated for vocal cord nodules and discuss the effect of psychological factors in the development, treatment, and resolution of vocal cord nodules in children. Seventy-seven children with bilateral true vocal cord nodules treated by observation, speech therapy, or surgery were submitted to prospective follow-up that included psychological testing in a subset of patients. Follow-up evaluation on 23 adult patients consisted of examination, social questionnaire, and psychological testing. Ninety-one percent had clinical resolution, and all were subjectively improved. There was no statistical difference in cure rate between the observation and speech therapy groups. Psychological testing revealed subtle but statistically significant differences in neuroticism in male children and extraversion in adults compared to controls. Psychological factors may play a role in the development of vocal cord nodules in children and needs to be further examined.