Summary
Objectives
Interpretation of laryngoscopy is an important diagnostic skill in otolaryngology.
There is, however, limited understanding of the specific visual strategies used while
assessing flexible laryngoscopy video. Eye-tracking technology allows for objective
study of eye movements during dynamic tasks. The purpose of the present study was
to explore visual gaze strategies during laryngoscopy interpretation of unilateral
vocal fold paralysis (UVFP) across clinician experience from novice to expert.
Methods
Thirty individuals were shown five flexible laryngoscopy videos, each 10 seconds long.
After viewing each video, participants reported their impressions of “left vocal fold
paralysis,” “right vocal fold paralysis,” or “no vocal fold paralysis.” Eye tracking
data were collected and analyzed for duration of fixation and number of fixations
on select areas of interest (AOI). Diagnostic accuracy and visual gaze patterns were
compared between novice, experienced, and expert groups.
Results
Diagnostic accuracy among learners in the novice group was significantly lower than
those in the more experienced groups (P = 0.04). All groups demonstrated similar visual gaze patterns when viewing the video
with normal bilateral vocal fold mobility, spending the greatest percentage of time
viewing the trachea. There were differences among groups when viewing the videos of
left or right VFP, but the trachea was always in the top three structures for greatest
fixation duration and highest number of fixations.
Conclusions
Eye-tracking is a novel tool in the setting of laryngoscopy interpretation. With further
study it has the potential to be useful for the training of otolaryngology learners
to improve diagnostic skills.
Key Words
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Article info
Publication history
Published online: March 31, 2023
Accepted:
February 24,
2023
Publication stage
In Press Corrected ProofFootnotes
Internal departmental funding was utilized without commercial sponsorship or support.
Identification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
