经鼻可弯曲喉镜分级系统。

A Grading System for Transnasal Flexible Laryngoscopy.

机构信息

Birecik State Hospital, Department of Otolaryngology, Head and Neck Surgery, Sanliurfa, Turkey.

Gulhane Medical School, Department of Otolaryngology, Head and Neck Surgery, Ankara, Turkey.

出版信息

J Voice. 2019 Sep;33(5):712-715. doi: 10.1016/j.jvoice.2018.02.019. Epub 2018 May 2.

DOI:10.1016/j.jvoice.2018.02.019

PMID:29730193

Abstract

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.

摘要

目的

经鼻软式喉镜（TFL）在喉科学临床实践中越来越受欢迎。目前尚无用于 TFL 的分级系统来帮助医生记录和交流喉部视野。本研究旨在根据清醒患者行 TFL 时对声门裂的可视化程度对喉部视野进行分类。

方法

3 位经验丰富的喉科学观察者对 920 例随机患者的 TFL 视频进行评估。检查包括声门、杓状软骨和会厌在内的喉部视图，并使用 5 分制分级系统对声门裂进行分类。使用κ（k）统计评估分级系统评分的观察者间一致性。

结果

本研究共纳入 920 例受试者。638 例（69.3%）为男性，282 例（30.6%）为女性，平均年龄为 40.13±15.08（18-89 岁）。构成 1 级的患者有 737 例（80.1%），2a 级有 122 例（13.2%），2b 级有 32 例（3.4%），3 级有 24 例（2.6%），4 级仅 5 例（0.5%）。观察者 1 和观察者 2 的评分之间的 k 值为 0.945（P<0.001），观察者 1 和观察者 3 的评分之间的 k 值为 0.933（P<0.001），观察者 2 和观察者 3 的评分之间的 k 值为 0.91（P<0.001）。