Optimal Position for Transnasal Flexible Laryngoscopy

Transnasal flexible laryngoscopy (TFL) is a simple, safe, and cost-effective procedure. TFL is routinely performed to awake patients in a sitting position but there is no a definite data about ideal head and neck position to be applied. The aim of this study is to determine which position is most ap...

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Bibliographic Details
Published in:Journal of voice 2020-05, Vol.34 (3), p.447-450
Main Authors: Tasli, Hamdi, Birkent, Hakan, Karakoc, Omer, Gokgoz, Mert Cemal
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Endoscopy
Female
Head
Humans
Laryngoscopes
Laryngoscopy - instrumentation
Male
Middle Aged
Neck
Neutral position
Patient Positioning
Posture
Predictive Value of Tests
Simple head extension
Sniffing
Transnasal flexible laryngoscopy
Young Adult
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Summary:Transnasal flexible laryngoscopy (TFL) is a simple, safe, and cost-effective procedure. TFL is routinely performed to awake patients in a sitting position but there is no a definite data about ideal head and neck position to be applied. The aim of this study is to determine which position is most appropriate to obtain the best laryngeal view during the TFL. The TFL videos of 132 randomized patients were evaluated by three blind observers experienced with laryngology. Three basic head positions; simple head extension (SHE), sniffing position (SP), and neutral position (NP) were performed during the TFL-Interobserver agreements for the grading system scores were assessed by using the kappa (k) statistic. For the SHE and SP, the numbers of patients constituting grade 1 were 127 (96.2%) and 126 (95.5%), respectively, while grade 2a were 5 (3.8%) and 6 (4.5%), respectively. In NP, the number of patients constituting grade 1 was 5 (3.8%), while grade 2a was 83 (62.9%), grade 2b was 37 (28%), and grade 3 was 7 (5.3%). The k score of the SHE was 0.826 (P < 0.001) between the ratings of observer 1 and observer 2, 0.905 (P < 0.001) between observer 1 and observer 3, and 0.919 (P < 0.001) between observer 2 and observer 3. These values denote nearly perfect agreement. A complete agreement was seen in 130 of the 132 (98.48%) videos. SHE and SP both provide a better glottic view than the NP and demonstrate the same success.
ISSN:0892-1997
1873-4588
DOI:10.1016/j.jvoice.2018.11.006