Usefulness of a newly developed endoscope for the observation of the posterior tracheal wall

Objective Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this...

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Published in:Laryngoscope investigative otolaryngology 2023-08, Vol.8 (4), p.963-969
Main Authors: Tamai, Tomoe, Yoshimi, Kanako, Nakagawa, Kazuharu, Yanagida, Ryosuke, Okumura, Takuma, Yamaguchi, Kohei, Ishii, Miki, Nagasawa, Yuki, Tohara, Haruka
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Language:English
Subjects:
Dysphagia
Endoscopy
Epiglottis
Laryngology, Speech and Language Science
Larynx
Neuromuscular diseases
Original Research
Statistical analysis
swallowing disorders
trachea
videoendoscopy
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container_title Laryngoscope investigative otolaryngology
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creator Tamai, Tomoe
Yoshimi, Kanako
Nakagawa, Kazuharu
Yanagida, Ryosuke
Okumura, Takuma
Yamaguchi, Kohei
Ishii, Miki
Nagasawa, Yuki
Tohara, Haruka
description Objective Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p 
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However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p &lt; .001), compared to only three of 20 participants with the CE. The time to observation of the posterior tracheal wall for examiners 1 and 2 was 13.3 ± 6.5 and 12.0 ± 6.7 s, respectively, with no difference between groups (p = .400). The kappa coefficients of examiners 1 and 2 and between the examiners were 0.444, 0.643, and 0.643, respectively, with concordance rates of 90%, 95%, and 95%, respectively. Conclusion Regardless of the examiner's years of experience, we observed that the two‐AE could observe the posterior tracheal wall. Level of Evidence Step 5. Regardless of the examiner's years of experience, we observed that the newly developed portable, flexible 2‐step angulation endoscope could observe the posterior tracheal wall.</description><identifier>ISSN: 2378-8038</identifier><identifier>EISSN: 2378-8038</identifier><identifier>DOI: 10.1002/lio2.1105</identifier><identifier>PMID: 37621293</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Dysphagia ; Endoscopy ; Epiglottis ; Laryngology, Speech and Language Science ; Larynx ; Neuromuscular diseases ; Original Research ; Statistical analysis ; swallowing disorders ; trachea ; videoendoscopy</subject><ispartof>Laryngoscope investigative otolaryngology, 2023-08, Vol.8 (4), p.963-969</ispartof><rights>2023 The Authors. published by Wiley Periodicals LLC on behalf of The Triological Society.</rights><rights>2023 The Authors. 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However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. 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However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p &lt; .001), compared to only three of 20 participants with the CE. The time to observation of the posterior tracheal wall for examiners 1 and 2 was 13.3 ± 6.5 and 12.0 ± 6.7 s, respectively, with no difference between groups (p = .400). The kappa coefficients of examiners 1 and 2 and between the examiners were 0.444, 0.643, and 0.643, respectively, with concordance rates of 90%, 95%, and 95%, respectively. Conclusion Regardless of the examiner's years of experience, we observed that the two‐AE could observe the posterior tracheal wall. Level of Evidence Step 5. 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subjects Dysphagia
Endoscopy
Epiglottis
Laryngology, Speech and Language Science
Larynx
Neuromuscular diseases
Original Research
Statistical analysis
swallowing disorders
trachea
videoendoscopy
title Usefulness of a newly developed endoscope for the observation of the posterior tracheal wall
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