Objectives: The prevalence of childhood dysphonia has varied from 6–9% in some reports to 38% in others. Dysphonia, especially the chronic type, harmed children's quality of life, many treatment modalities for benign vocal fold lesions have been present, including surgical management and voice therapy as well as medical treatment according to the condition, the study aimed to compare the outcome of voice therapy versus surgical therapy of VFs (vocal folds) nodules and cysts among children.
Methods: A prospective cohort study was conducted, containing two groups, a voice therapy group (40 patients) and a surgical group (20 patients), auditory perceptual assessment (APA), stroboscopy, and acoustic analysis were done at baseline and post-treatment assessments.

Results: Vocal fold nodule is the underlying pathology in two-thirds of included patients followed by vocal fold cysts (33.3%). In the baseline assessment, both studied groups had matched findings with non-significant differences, also, both groups showed a large glottal gap in the baseline assessment. Meanwhile, in post-treatment assessment, reduced glottal gab was noted similarly in both groups, but APA measures had better results in the voice therapy group, also it is more aperiodic. While the acoustic analysis was non-significant between both groups post-treatment, both groups recorded a post-treatment improvement in all measures. Still, unfortunately, the surgical group recorded 4 complicated cases (20%) including synechiae.
Conclusions: vocal folds nodules and cysts are common among children, and both voice therapy and surgical treatment are effective with some superiority for voice therapy. Avoidance of surgical complications is another advantage.