Awake Flexible Fiberoptic Laryngoscopy to diagnose glossoptosis in Robin Sequence patients.

Autor:	Basart H; Department of Pediatrics, Academic Medical Center/Emma Pediatric Hospital, Amsterdam, Netherlands.; Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands., König AM; Department of Otolaryngology, Academic Medical Center, Amsterdam, Netherlands. a.m.konig-jung@amc.uva.nl., Bretschneider JH; Department of Otolaryngology, VU Medical Center, Amsterdam, Netherlands., Hoekstra CE; Department of Otolaryngology, Academic Medical Center, Amsterdam, Netherlands., Oomen KP; Department of Otolaryngology, Utrecht Medical Center/Wilhelmina Children's Hospital, Utrecht, Netherlands., Pullens B; Department of Otolaryngology, Erasmus Medical Center/Sophia Pediatric Hospital, Rotterdam, Netherlands., Rinkel RN; Department of Otolaryngology, VU Medical Center, Amsterdam, Netherlands., van Gogh CD; Department of Otolaryngology, VU Medical Center, Amsterdam, Netherlands., van der Horst CM; Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands., Hennekam RC; Department of Pediatrics, Academic Medical Center/Emma Pediatric Hospital, Amsterdam, Netherlands.
Jazyk:	angličtina
Zdroj:	Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery [Clin Otolaryngol] 2016 Oct; Vol. 41 (5), pp. 467-71. Date of Electronic Publication: 2016 Feb 09.
DOI:	10.1111/coa.12552
Abstrakt:	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. (© 2015 John Wiley & Sons Ltd.)
Databáze:	MEDLINE
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