Summary
Objective
Transnasal flexible laryngoscopy (TFL) is becoming more popular in laryngology clinical
practice. There has not been any grading system for TFL to help the physician document
and communicate the laryngeal view yet. In this study, we aimed to classify the laryngeal
view based on the visualization of the glottic aperture with TFL performed on conscious
patients.
Methods
The TFL videos of 920 randomized patients were evaluated by three blind observers
experienced with laryngology. The laryngeal view, consisting of the basic anatomic
landmarks of the glottis, arytenoids, and epiglottis, was examined, and the glottic
aperture was classified with a five-point grading system. Interobserver agreements
for the grading system scores were assessed by using the kappa (k) statistic.
Results
Nine hundred and twenty subjects were enrolled in the study. Six hundred and thirty-eight
(69.3%) were men, and 282 (30.6%) were women, and the mean age was 40.13 ± 15.08 (18–89
years). The number of patients constituting grade 1 was 737 (80.1%), while grade 2a
was 122 (13.2%), grade 2b was 32 (3.4%), grade 3 was 24 (2.6%), and finally, grade
4 was only 5 (0.5%). The k score was 0.945 (P < 0.001) between the ratings of observer 1 and observer 2, 0.933 (P < 0.001) between observer 1 and observer 3, and 0.91 (P < 0.001) between observer 2 and observer 3.
Conclusion
This new grading system for the laryngeal view can help physicians assess the upper
airways, and it can also help visualize how much of a glottic opening there is.
Key Words
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Article info
Publication history
Published online: May 02, 2018
Accepted:
February 21,
2018
Footnotes
Each of the authors has contributed to, read, and approved this manuscript.
This manuscript is original and it, or any part of it, has not been previously published; nor is it under consideration for publication elsewhere.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
This work was prepared in Gulhane Medical School, Department of Otolaryngology, Head and Neck Surgery, Ankara, Turkey.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
