# The Impact of Nasal Patency on Vocal Fold Nodule Formation in Children

## TL;DR

This study explores how nasal patency and breathing patterns in children relate to the formation of vocal fold nodules.

## Contribution

The study provides new insights into nasal and breathing factors associated with vocal fold nodules in children.

## Key findings

- Children with vocal fold nodules snored and breathed through their mouths less than the control group.
- Pathological mucous coverage of the adenoid was more common in children with vocal fold nodules.
- Adenoid size was smaller in children with vocal fold nodules compared to the control group.

## Abstract

Objectives: This study aimed to endoscopically assess nasal patency in terms of adenoid obstruction and its mucous coverage, as well as nasal obstruction caused by the inferior nasal turbinate in children with vocal fold nodules. Methods: A retrospective study was conducted involving 54 children admitted to an ENT clinic due to hoarseness caused by vocal fold nodules from 2022 to 2024. The study analyzed medical history, the results of performed flexible nasofiberoscopy and tympanometry. Results: Children with vocal fold nodules snored and slept with open mouths less frequently than the control group of other patients admitted to the ENT outpatient clinic without voice disorders (p = 0.003 and 0.004, respectively). Pathological mucous coverage of the adenoid was observed more often (p = 0.02). The mean adenoid size in the A/C ratio was 52.1% compared to 63.4% in the control group (p = 0.01). Conclusions: Children with vocal fold nodules typically have smaller adenoids, fewer incidents of snoring and open-mouth breathing, but more frequent pathological nasal mucus. It was not possible to prove that the incorrect breathing path through the mouth, causing reduced humidity of the inhaled air, affects the formation of vocal fold nodules.