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. 2022 Jul;47(4):516-520.
doi: 10.1111/coa.13936. Epub 2022 Apr 24.

Laryngoscopic findings of age-related vocal fold atrophy are reliable but not specific

Jin Soo Song  1 , Ross Campbell  2 , Rui Jun Lin  3 , Caroline C Jeffery  1   4
Affiliations

Laryngoscopic findings of age-related vocal fold atrophy are reliable but not specific

Jin Soo Song et al. Clin Otolaryngol. 2022 Jul.

Abstract

Objectives: We aimed to evaluate the reliability of laryngoscopic features of vocal fold atrophy as assessed by novice otolaryngology trainees and expert laryngologists.

Design: Two expert fellowship-trained laryngologists and three non-expert otolaryngology resident trainees were recruited to view 50 anonymised laryngo-stroboscopic examinations of patients presenting with dysphonia and non-voice, laryngeal complaints. Reviewers were asked to stratify the patient's age, provide an opinion about the presence of age-related vocal fold atrophy and specify which laryngoscopy features were present to make the diagnosis.

Setting: Tertiary care laryngology practice.

Participants: Two fellowship-trained laryngologists and three trainee otolaryngologists.

Main outcome measures: Accuracy of age categorisation was determined and Kappa analysis was performed to assess inter-rater agreement.

Results: The mean age of patients was 54.9 years old with near equal male to female distribution. The overall accuracy of age category determination by raters was only 30.8%. Kappa analysis demonstrated fair agreement regarding the presence of vocal fold atrophy in non-expert reviewers, and moderate agreement amongst expert reviewers. Features of glottic gap, muscular atrophy of vocal folds and prominent vocal processes were all identified with high agreement (>80.0%).

Conclusion: Our study illustrates that while raters can agree on the presence of age-related vocal fold atrophy, the findings may be non-specific and do not necessarily correlate with age.

Keywords: presbylaryngis; presbylarynx; videolaryngoscopy; vocal fold atrophy.

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References

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