Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis

Area of Science:

• Otolaryngology
• Medical Imaging
• Respiratory Medicine

Background:

• Subglottic stenosis (SGS) is a condition causing subglottic narrowing and significant morbidity.
• Current endoscopic and radiographic assessments for SGS may lack consistency in clinical practice.

Purpose of the Study:

• To evaluate the concordance between endoscopic and radiographic grading of subglottic stenosis.
• To compare the Cotton-Myer classification system with radiographic measurements of stenosis severity.

Main Methods:

• 33 endoscopic procedures for subglottic stenosis were reviewed using the Cotton-Myer classification.
• A blinded radiologist measured stenosis from radiographic imaging within 3 months of endoscopic evaluation.
• Statistical analyses, including Spearman and Pearson correlations, were used to compare grading methods.

Main Results:

• Only 45.5% of endoscopic evaluations agreed with Cotton-Myer scoring.
• Significant discrepancies (1-2 grades) were observed in 54.6% of cases.
• Weak correlations were found between endoscopic and radiographic percentage stenosis measurements (Spearman: 0.233, Pearson: 0.138).

Conclusions:

• Radiographic and endoscopic grading of subglottic stenosis demonstrate poor reliability and concordance in clinical practice.
• Current assessment methods may not provide consistent evaluations, potentially affecting patient management.