Using Office-Based Zero-Degree Rigid Laryngoscopy to Predict Glottic Exposure in Microlaryngoscopy

Area of Science:

• Otolaryngology
• Surgical Endoscopy
• Diagnostic Imaging

Background:

• Poor glottic exposure during microlaryngeal surgery (MLS) can impede instrumentation and affect surgical outcomes.
• Preoperative prediction of glottic exposure is crucial for surgical planning and success.

Purpose of the Study:

• To evaluate the diagnostic utility of 4-mm zero-degree rigid endoscopic laryngeal examination in predicting glottic exposure during MLS.
• To compare the predictive accuracy of zero-degree laryngoscopy with the Laryngoscore.

Main Methods:

• A cross-sectional observational study involving 35 adult participants undergoing MLS.
• Preoperative assessment using 4-mm zero-degree rigid laryngoscopy and the Laryngoscore.
• Glottic exposure was graded, and participants were categorized into good or difficult laryngeal exposure groups. Receiver operating characteristic (ROC) curve analysis was performed.

Main Results:

• Zero-degree laryngoscopy demonstrated a high area under the curve (AUC) of 0.97, indicating excellent predictive accuracy.
• The Laryngoscore had an AUC of 0.83.
• Optimal cut-off values showed zero-degree laryngoscopy with 93.3% sensitivity and 100% specificity for predicting difficult laryngeal exposure, outperforming the Laryngoscore.

Conclusions:

• Zero-degree laryngoscopy is an excellent and highly accurate predictor of glottic exposure in microlaryngeal surgery.
• This endoscopic technique surpasses the Laryngoscore in identifying patients who may experience difficult glottic exposure during MLS.