Video rigid laryngeal endoscopy compared to laryngeal mirror examination: an assessment of patient comfort and clinical visualization.
OBJECTIVE
To determine whether there are differences in patient preference and extent of laryngeal visualization between video rigid (30 degree endoscope) laryngoscopy (VRL) and laryngeal mirror examination (LME).


METHODS
A prospective comparison by patients undergoing laryngeal examination by both VRL and LME conducted by two examiners experienced in both mirror and rigid video endoscopy.


METHODS
Forty-three patients had laryngeal examination by both VRL and LME in alternating order. Patients were instructed to observe their exam on a monitor screen during the rigid exam. At the conclusioon of both laryngeal examinations, patients were asked to rank comfort and level of gagging on a 1 to 10 scale for both VRL and LME, as well as preference between the two methods and whether seeing their laryngeal examination on the video screen was helpful. The extent of laryngeal visualization by the clinician was recorded for each examination.


RESULTS
Patient comfort level was greater with VRL (P < .001) and gagging was significantly less with VRL (P < .001) compared to LME. VRL provided a more complete examination of the larynx by the clinician (P < .001) compared to LME. Patient preference significantly favored VRL (79.1%) compared to LME (18.4%) and 2.3% had no preference (P < .001) A total of 83.7% found visualization of laryngeal exam on the monitor during the VRL helpful.


CONCLUSIONS
VRL is superior to LME for most patients based on comfort, extent of laryngeal examination by the clinician, and patient preference. The majority of patients found visualization of their laryngeal examination during VRL to be helpful.
Dunklebarger
Joshua
J
Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Rhee
Diane
D
Kim
Seungwon
S
Ferguson
Berrylin
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005260:Female; D005683:Gagging; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014741:Video Recording