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- Title
Awake Flexible Fiberoptic Laryngoscopy to diagnose glossoptosis in Robin Sequence patients.
- Authors
Basart, H.; König, A.M.; Bretschneider, J.H.; Hoekstra, C.E.L.; Oomen, K.P.Q.; Pullens, B.; Rinkel, R.N.P.M.; Gogh, C.D.L.; Horst, C.M.A.M.; Hennekam, R.C.
- Abstract
Background Robin Sequence ( RS) is usually defined as the combination of micrognathia, glossoptosis and upper airway obstruction. No objective criteria to diagnose RS exist. To compare management strategy results, a single RS definition using objective criteria is needed. The most frequently used primary diagnostic tool for glossoptosis is awake Flexible Fiberoptic Laryngoscopy ( aFFL). Objectives To determine the reliability of the aFFL videos as an independent diagnostic tool itself, rather than on the complete evaluation of a patient. Design, setting, participants All RS individuals from an existing cohort with an available aFFL video were included retrospectively. Thirty age-matched patients without pathologic findings on aFFL were used as controls. aFFL videos were scored by six otolaryngologists as: a. Marked glossoptosis, b. Mild glossoptosis, c. Severity unknown, d. No glossoptosis, e. Insufficient video quality. Videos were anonymised and rated twice, in altered sequences, after a washout period of minimally 2 weeks. Main outcome measures Inter-rater and intrarater agreement. Results Twenty-six videos of 16 RS patients and 30 videos of controls were included. Inter-rater agreement was fair in the whole group ( κ: 0.320) and RS group ( κ: 0.226), and fair to moderate in determining presence of glossoptosis (total group κ: 0.430; RS κ: 0.302; controls κ: 0.212). The intrarater agreement for the presence of glossoptosis in RS was moderate ( κ: 0.541). Conclusions aFFL offers fair to moderate inter-rater agreement, with moderate intrarater agreement, in evaluating glossoptosis in RS. Using aFFL as the single tool in choosing management strategies in RS seems insufficient. There is need for a more reliable, patient friendly diagnostic tool or an internationally accepted aFFL scoring system, to diagnose glossoptosis in RS.
- Subjects
MICROGNATHIA; RESPIRATORY obstructions; DISEASE management; MEDICAL records; MEDICAL care
- Publication
Clinical Otolaryngology, 2016, Vol 41, Issue 5, p467
- ISSN
1749-4478
- Publication type
Article
- DOI
10.1111/coa.12552