A Novel Grading System for Supraglottic Stenosis Based on Morphology and Functional Status

Area of Science:

• Otolaryngology
• Airway Management
• Medical Device Development

Background:

• Supraglottic stenosis lacks a standardized severity classification system.
• Existing methods hinder effective communication and patient status assessment.

Purpose of the Study:

• To develop a novel grading system for supraglottic stenosis.
• To assess the reliability of this new grading system for clinical use.

Main Methods:

• Retrospective analysis of 28 supraglottic stenosis cases across three institutions.
• Development of a grading system by laryngologist focus groups based on morphology and function.
• Inter-rater and intra-rater reliability testing using quadratic-weighted kappa coefficients.

Main Results:

• The novel grading system demonstrated substantial to almost perfect inter-rater reliability (Kw = 0.79-0.81).
• Intra-rater reliability was consistently almost perfect (0.88-1.0).
• Morphological features like epiglottic and arytenoid fixation correlated with poorer functional outcomes.

Conclusions:

• A reliable grading system for supraglottic stenosis has been successfully developed.
• The proposed system effectively describes both stenosis morphology and patient functional status.
• This tool enhances provider communication and patient care for supraglottic stenosis.