Abstract：
BACKGROUND: The bowing index (BI) and normalized glottal gap area (NGGA) are used to quantify vocal fold morphology in ARVA; however, the influence of the distance between the flexible laryngoscope lens and the target area is not known. The goal is to test whether the endoscopic distance impacts vocal fold morphology measurements in patients with ARVA during flexible video laryngostroboscopy (VLS).
METHODS: Patients with ARVA who underwent VLS were included. Images were classified into near (close to the petiole of the epiglottis) and far (below nasopharynx, with tongue base and entire epiglottis visible) conditions. BI was calculated using a mobile application, and NGGA was measured using ImageJ.
RESULTS: This study included 23 patients; the mean age was 77 ± 7 years. Mean BI measured at the near distance was higher than far distances with a mean difference of 1.94 (95% CI: 0.92-2.96, p = 0.001). NGGA showed difference with changed distance -0.24 (95% CI: -0.48 to 0.01, p < 0.05).When stratifying patients into two groups based on median BI measurement, there was a statistically significant difference between near and far conditions, with increased BI in the near condition for patients above the median (p < 0.05), but no difference between the near and far condition for patients with BI below the median.
CONCLUSIONS: The BI and NGGA were impacted by the endoscopic distance during flexible VLS. BI was significantly higher in the near condition compared with the far condition. The difference in BI between the near and far conditions was more pronounced when the vocal fold bowing was greater. These findings call for heightened awareness of measurement discrepancies secondary to the endoscopic distance during flexible laryngostroboscopy.
METHODS: Level 2 Laryngoscope, 2024.
METHODS: Patients with ARVA who underwent VLS were included. Images were classified into near (close to the petiole of the epiglottis) and far (below nasopharynx, with tongue base and entire epiglottis visible) conditions. BI was calculated using a mobile application, and NGGA was measured using ImageJ.
RESULTS: This study included 23 patients; the mean age was 77 ± 7 years. Mean BI measured at the near distance was higher than far distances with a mean difference of 1.94 (95% CI: 0.92-2.96, p = 0.001). NGGA showed difference with changed distance -0.24 (95% CI: -0.48 to 0.01, p < 0.05).When stratifying patients into two groups based on median BI measurement, there was a statistically significant difference between near and far conditions, with increased BI in the near condition for patients above the median (p < 0.05), but no difference between the near and far condition for patients with BI below the median.
CONCLUSIONS: The BI and NGGA were impacted by the endoscopic distance during flexible VLS. BI was significantly higher in the near condition compared with the far condition. The difference in BI between the near and far conditions was more pronounced when the vocal fold bowing was greater. These findings call for heightened awareness of measurement discrepancies secondary to the endoscopic distance during flexible laryngostroboscopy.
METHODS: Level 2 Laryngoscope, 2024.
摘要：
背景：弯曲指数（BI）和归一化声门间隙面积（NGGA）用于量化ARVA中的声带形态；但是，柔性喉镜透镜和目标区域之间的距离的影响是未知的。目的是测试在柔性视频喉镜检查（VLS）期间，内窥镜距离是否会影响ARVA患者的声带形态测量。
方法：纳入接受VLS的ARVA患者。图像分为近（靠近会厌叶柄）和远（鼻咽以下，舌根和整个会厌可见）状况。BI是使用移动应用程序计算的，和使用ImageJ测量NGGA。
结果：本研究纳入23例患者，平均年龄77±7岁。在近距离测量的平均BI高于远距离，平均差为1.94（95％CI：0.92-2.96，p=0.001）。NGGA显示随距离变化的差异-0.24（95％CI：-0.48至0.01，p<0.05）。当根据中位数BI测量将患者分为两组时，近条件和远条件之间有统计学上的显著差异，高于中位数（p<0.05）的患者的近期BI增加，但是BI低于中位数的患者的远近状况没有差异。
结论：在柔性VLS期间，BI和NGGA受到内镜距离的影响。近条件下的BI明显高于远条件。当声带弯曲较大时，近条件和远条件之间的BI差异更为明显。这些发现要求在柔性喉镜检查期间提高对内窥镜距离继发的测量差异的认识。
方法：二级喉镜，2024.
方法：纳入接受VLS的ARVA患者。图像分为近（靠近会厌叶柄）和远（鼻咽以下，舌根和整个会厌可见）状况。BI是使用移动应用程序计算的，和使用ImageJ测量NGGA。
结果：本研究纳入23例患者，平均年龄77±7岁。在近距离测量的平均BI高于远距离，平均差为1.94（95％CI：0.92-2.96，p=0.001）。NGGA显示随距离变化的差异-0.24（95％CI：-0.48至0.01，p<0.05）。当根据中位数BI测量将患者分为两组时，近条件和远条件之间有统计学上的显著差异，高于中位数（p<0.05）的患者的近期BI增加，但是BI低于中位数的患者的远近状况没有差异。
结论：在柔性VLS期间，BI和NGGA受到内镜距离的影响。近条件下的BI明显高于远条件。当声带弯曲较大时，近条件和远条件之间的BI差异更为明显。这些发现要求在柔性喉镜检查期间提高对内窥镜距离继发的测量差异的认识。
方法：二级喉镜，2024.
