Summary
Objective
To compare flexible distal-chip laryngoscopy (FDL) and rigid telescopic laryngoscopy
(RTL) in image quality and diagnostic ability.
Study Design
Prospective cohort study; blinded comparison.
Methods
Eighteen normal adult subjects were recruited to undergo both FDL and RTL and normalized
videos were recorded. Three blinded laryngologists compared the videos for color fidelity,
illumination, resolution, and vascularity, and indicated superiority with FDL, RTL,
or no difference. Raters also reported if an abnormality was seen and in which video
it was better visualized. Videos for two subjects were repeated to assess intra-rater
reliability, making 20 video comparisons across 3 raters for a total of 60 ratings.
Differences in responses were analyzed via Mann-Whitney U and Pearson Χ2. Inter-rater reliability was assessed via Fleiss’ kappa, and intra-rater reliability
was assessed via percent agreement.
Results
RTL was rated superior in all categories of image quality (47 vs 5 vs 8, P < 0.01; 47 vs 7 vs 6, P < 0.01; 51 vs 5 vs 4, P<0.01; 44 vs 9 vs 7, P < 0.01, respectively). An abnormality was seen 33 times with both modalities and
6 times with RTL only. When seen with both modalities, visualization was superior
in RTL compared with FDL (29 vs 4, P <0.01).
Conclusions
There was significant superiority of RTL in all categories of image quality, with
slight inter-rater agreement for color fidelity, resolution, and vascularity. RTL
was also significantly better for visualization of abnormalities. These findings suggest
superior image quality in RTL compared with FDL, but further research is required
to determine if this difference is clinically significant.
Key Words
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Article info
Publication history
Published online: March 26, 2021
Accepted:
February 2,
2021
Footnotes
Declarations of interest: none
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
