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Differences in the diagnostic value between fiberoptic and high definition laryngoscopy for the characterisation of pharyngeal and laryngeal lesions: A multi-observer paired analysis of videos

Scholman, C., Westra, J. M., Zwakenberg, M. A., Dikkers, F. G., Halmos, G. B., Wedman, J., Wachters, J. E., van der Laan, B. F. A. M. & Plaat, B. E. C., Jan-2020, In : Clinical Otolaryngology. 45, 1, p. 119-125 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

Objectives High definition laryngoscopy (HDL) could lead to better interpretation of the pharyngeal and laryngeal mucosa than regularly used fiberoptic laryngoscopy (FOL). The primary aim of this study is to quantify the diagnostic advantage of HDL over FOL in detecting mucosal anomalies in general, in differentiating malignant from benign lesions and in predicting specific histological entities. The secondary aim is to analyse image quality of both laryngoscopes. Design Retrospective paired analysis with multiple observers evaluating endoscopic videos simulating daily clinical practice. Setting A tertiary referral hospital. Participants In 36 patients, both FOL and HDL videos were obtained. Six observers were provided with additional clinical information, and 36 FOL and HDL videos were evaluated in a randomised order. Main outcome measures Sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of observers using both flexible laryngoscopes were calculated for detection of mucosal lesions in general and uncovering malignant lesions. Sensitivities were calculated for prediction of specific histological entities. Image quality (scale 1-10) was assessed for both flexible laryngoscopes. Results HDL reached higher sensitivity compared to FOL for detection of mucosal abnormalities in general (96.0% vs 90.4%; P = .03), differentiating malignant from benign lesions (91.7% vs 79.8%; P = .03) and prediction of specific histological entities (59.7% vs 47.2%; P <.01). Image quality was judged better with HDL in comparison with FOL (mean: 8.4 vs 5.4, P <.01). Conclusions HDL is superior to FOL in detecting mucosal anomalies in general, malignancies and specific histological entities. Image quality is considered as superior using HDL compared to FOL.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalClinical Otolaryngology
Volume45
Issue number1
Publication statusPublished - Jan-2020

    Keywords

  • laryngeal mucosa, laryngoscopy, larynx, mucous membrane, neoplasms, pharynx, sensitivity and specificity, CANCER, ACCURACY, SYSTEM, HEAD

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