Flexible nasolaryngoscopy accuracy in laryngomalacia diagnosis.
Laryngomalacia is the most common cause of stridor in infancy. Diagnosis is established by associating the clinical manifestations with laryngoscopic findings in a dynamic form.


OBJECTIVE
To analyze diagnostic accuracy of laryngomalacia through flexible nasolaryngoscopy performed by four different examiners. Form of studying: Comparison of diagnostic tests (clinical study).


METHODS
A protocol of videolaryngoscopic evaluation for patients with laryngomalacia was created encompassing the following items: anterior displacement of the arytenoids; omega-shaped epiglottis; short aryepiglottic folds; posterior displacement of epiglottis; vocal folds being visible or not; edema of the posterior larynx. Four different examiners analyzed the videolaryngoscopic examinations of 18 patients with established diagnosis of laryngomalacia previously established by clinical data, epidemiology and anatomical traits. The four observers knew previously that the patients had laryngomalacia and which criteria should be analyzed in the evaluation protocol. Observers were unaware of the results each one found.


RESULTS
diagnostic agreement average considering all parameters evaluated was of 88.2%.


CONCLUSIONS
Dynamic flexible nasolaryngoscopy is a proven diagnostic method, regardless of physician experience.
Lima
Tania Mara Assis
TM
Dept. Otorrinolaringologia, FM, UFMG, MG, Brazil.
Gonçalves
Denise Utsch
DU
Gonçalves
Lucas V
LV
Reis
Paulo Augusto C
PA
Lana
Angela Beatriz S
AB
Guimarães
Fernando F
FF
D002983:Clinical Competence; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis*; D007828:Laryngoscopy / Q000379:methods*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity