Accuracy and Reliability of 4D-CT and Flexible Laryngoscopy in Upper Airway Evaluation in Robin Sequence
In: Otolaryngology–Head and Neck Surgery, Jg. 166 (2021), Heft 4, S. 760-767
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Zugriff:
Objectives To evaluate the performance of 4-dimensional computed tomography (4D-CT) in assessing upper airway obstruction (UAO) in patients with Robin sequence (RS) and compare the accuracy and reliability of 4D-CT and flexible fiber-optic laryngoscopy (FFL). Study Design Prospective survey of retrospective clinical data. Setting Single, tertiary care pediatric hospital. Methods At initial and 30-day time points, a multidisciplinary group of 11 clinicians who treat RS rated UAO severity in 32 sets of 4D-CT visualizations and FFL videos (dynamic modalities) and static CT images. Raters assessed UAO at the velopharynx and oropharynx (1 = none to 5 = complete) and noted confidence levels of each rating. Intraclass correlation and Krippendorff alpha were used to assess intra- and interrater reliability, respectively. Accuracy was assessed by comparing clinician ratings with quantitative percentage constriction (QPC) ratings, calculated based on 4D-CT airway cross-sectional area. Results were compared using Wilcoxon rank-sum and signed-rank tests. Results There was similar intrarater agreement (moderate to substantial) with 4D-CT and FFL, and both demonstrated fair interrater agreement. Both modalities underestimated UAO severity, although 4D-CT ratings were significantly more accurate, as determined by QPC similarity, than FFL (−1.06 and −1.46 vs QPC ratings, P = .004). Overall confidence levels were similar for 4D-CT and FFL, but other specialists were significantly less confident in FFL ratings than were otolaryngologists (2.25 and 3.92, P < .0001). Conclusion Although 4D-CT may be more accurate in assessing the degree of UAO in patients with RS, 4D-CT and FFL assessments demonstrate similar reliability. Additionally, 4D-CT may be interpreted with greater confidence by nonotolaryngologists who care for these patients.
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Accuracy and Reliability of 4D-CT and Flexible Laryngoscopy in Upper Airway Evaluation in Robin Sequence
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Autor/in / Beteiligte Person: | Lam, Austin S. ; Bindschadler, Michael D. ; Evans, Kelly N. ; Friedman, Seth D. ; Blessing, Matthew S. ; Bly, Randall ; Cunningham, Michael L. ; Egbert, Mark A. ; Ettinger, Russell E. ; Gallagher, Emily R. ; Hopper, Richard A. ; Johnson, Kaalan ; Perkins, Jonathan A. ; Romberg, Erin K. ; Sie, Kathleen C. Y. ; Susarla, Srinivas M. ; Zdanski, Carlton J. ; Wang, Xing ; Otjen, Jeffrey P. ; Perez, Francisco A. ; Dahl, John P. ; National Institute on Deafness and Other Communication Disorders ; Seattle Children’s Research Institute |
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Zeitschrift: | Otolaryngology–Head and Neck Surgery, Jg. 166 (2021), Heft 4, S. 760-767 |
Veröffentlichung: | SAGE Publications, 2021 |
Medientyp: | academicJournal |
ISSN: | 0194-5998 |
DOI: | 10.1177/01945998211027353 |
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