The “Clinical Challenges in Otolaryngology” article by Wohl is tackling a difficult and controversial issue of pediatric voice disorders. He presents his case that vocal cord nodules in children are best managed without surgery.
At our institution, the workup of these children is similar; however, unlike Wohl, we believe that there are consistent norms1,2 for pediatric acoustic analysis and we use these norms as the standard end point to be achieved. Acoustic analysis can be used to objectively assess improvement in voice quality during and after voice therapy.
Zalzal GH. Medical Treatment of Pediatric Voice Disorders. Arch Otolaryngol Head Neck Surg. 2005;131(1):71. doi:10.1001/archotol.131.1.71