小児声帯結節の臨床経過

Clinical course of pediatric vocal nodules

I．はじめに

　小児における嗄声の原因疾患のうち，最も頻度の高い声帯結節は男児に多く，変声に伴って治癒することが多いといわれているが^1），症例を経時的に観察して自然経過を検討した報告は少ない。今回われわれは，当科音声外来で長期にわたり経過観察し得た小児声帯結節症例26例について，内視鏡所見，聴覚印象，呼気流率の推移を経時的に観察して検討したので報告する。

We investigated the clinical course of 26 cases of pediatric vocal nodules. The main study items included endoscopic findings,auditory impression（G）,and the shift of expiration flow rate at vocalization of easy phonation（FLOW）. Improvement tended to obtain in the children around 8 years old before voice mutation and cure was achieved in these around 11 years old in many cases. The mechanism of the improvement of vocal nodules before voice mutation was thought to be involving endocrine mechanism,such as rapid increase in male hormones at the age of seven to eight,which promote laryngeal changes.