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A Grading System for Transnasal Flexible Laryngoscopy.

Hamdi Tasli1, Omer Karakoc2, Hakan Birkent2

  • 1Birecik State Hospital, Department of Otolaryngology, Head and Neck Surgery, Sanliurfa, Turkey.

Journal of Voice : Official Journal of the Voice Foundation
|May 7, 2018
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Summary

A new grading system for transnasal flexible laryngoscopy (TFL) classifies the laryngeal view. This system aids physicians in documenting and communicating glottic aperture visualization during TFL procedures.

Keywords:
Direct laryngoscopyEndoscopyGrading systemLarynxTransnasal flexible laryngoscopy

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Area of Science:

  • Otolaryngology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Transnasal flexible laryngoscopy (TFL) is increasingly utilized in laryngology.
  • A standardized grading system for TFL is currently lacking for documentation and communication.
  • Objective assessment of the laryngeal view is crucial for clinical practice.

Purpose of the Study:

  • To develop and validate a novel grading system for the laryngeal view obtained via TFL.
  • To classify the visualization of the glottic aperture during TFL in conscious patients.
  • To establish a reliable method for documenting TFL findings.

Main Methods:

  • Evaluation of 920 TFL videos by three experienced laryngologists.
  • Classification of the laryngeal view, including glottic aperture, using a five-point grading system.
  • Assessment of interobserver agreement using the kappa (k) statistic.

Main Results:

  • The study included 920 patients (69.3% male, mean age 40.13 years).
  • Distribution of grades: Grade 1 (80.1%), Grade 2a (13.2%), Grade 2b (3.4%), Grade 3 (2.6%), Grade 4 (0.5%).
  • High interobserver agreement was observed (k scores ranging from 0.91 to 0.945, P < 0.001).

Conclusions:

  • A new five-point grading system for TFL effectively classifies the laryngeal view.
  • This system enhances the assessment of upper airways and visualization of glottic opening.
  • The grading system demonstrates high reliability and can aid clinical documentation and communication.