Abstract
Objectives:
Evaluate the diagnostic accuracy of flexible fiberoptic examinations of the larynx recorded directly onto smartphones using a novel coupling device.
Methods:
Prospective, blinded study at a tertiary referral hospital. Inpatients requiring laryngoscopy underwent bedside flexible fiberoptic endoscopy. A smartphone was then attached to the endoscope using a novel coupling device and the same examination was recorded. The laryngologist performing the live examination documented their findings on a standardized scoring sheet. A second laryngologist, blinded to the findings of the first, evaluated the recorded examination using an identical scoring sheet.
Results:
Eighteen patients were evaluated from July 2013 to January 2014. Evaluation of airway patency was identical (Kappa 1.0, P < .001). Evaluation of vocal cord motion was identical for 14 subjects: 9 normal, 3 paretic, 2 paralytic (Kappa 0.687, P < .001). There was no disagreement on the sidedness of the vocal fold involved (3 left, 1 right, 1 bilateral). There was 1 paretic-paralytic and 2 normal-paretic discrepancies. Subjective evaluation of the mucosa over each subsite showed moderate reliability (Kappa 0.515, P < .001).
Conclusions:
There is high correlation between laryngeal diagnoses using live flexible fiberoptic laryngoscopy and recordings of those examinations using a coupling device to transfer the recordings on to smart phones. Critical findings such as airway patency and vocal fold motion showed the highest correlation, subjective evaluation of the quality of the mucosa showed more variability.
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