Laryngeal examination: a comparison of mirror examination with a rigid lens system

Indirect mirror laryngoscopy is the standard screening examination used in patients with complaints referable to the larynx and upper aerodigestive tract. The purpose of this study was to prospectively evaluate, in 100 patients, the diagnostic accuracy and examination success rate of indirect laryngoscopy versus a rigid rod examination. Fifty-two percent of mirror examinations were successful as were 83% of rod exams. This was a significant difference in success rate. From the 29 patients who underwent direct laryngoscopy, one false negative and one false positive mirror examination and one false positive rod examination were found. We conclude that the mirror is a useful screening tool so long as strict examination criteria are used. The rigid rod adds further diagnostic information in those patients who cannot be evaluated with a mirror.