Glottic Keratosis: Significance and Identification of Laryngoscopic Findings
Objective Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings. Study Desi...
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Published in | OTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation Vol. 5; no. 1; pp. 2473974X21994743 - n/a |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.01.2021
John Wiley & Sons, Inc Wiley |
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Abstract | Objective
Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings.
Study Design
Retrospective case-control study.
Setting
Tertiary care university hospital.
Methods
Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high-grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss’s κ.
Results
Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high-grade dysplasia and carcinoma, P = .002 and P = .03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy.
Conclusion
The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high-grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice-based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. |
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AbstractList | Objective
Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings.
Study Design
Retrospective case-control study.
Setting
Tertiary care university hospital.
Methods
Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high-grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss’s κ.
Results
Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high-grade dysplasia and carcinoma, P = .002 and P = .03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy.
Conclusion
The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high-grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice-based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. OBJECTIVEGlottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings. STUDY DESIGNRetrospective case-control study. SETTINGTertiary care university hospital. METHODSAdults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high-grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss's κ. RESULTSSixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high-grade dysplasia and carcinoma, P = .002 and P = .03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy. CONCLUSIONThe presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high-grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice-based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. Objective Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings. Study Design Retrospective case-control study. Setting Tertiary care university hospital. Methods Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high-grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss’s κ. Results Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high-grade dysplasia and carcinoma, P = .002 and P = .03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy. Conclusion The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high-grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice-based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. Objective Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings. Study Design Retrospective case‐control study. Setting Tertiary care university hospital. Methods Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high‐grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss’s κ. Results Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high‐grade dysplasia and carcinoma, P =. 002 and P =. 03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy. Conclusion The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high‐grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice‐based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We determined the significance of laryngoscopic findings and agreement among clinicians to identify those specific findings. Retrospective case-control study. Tertiary care university hospital. Adults with glottic keratosis with preoperative office laryngoscopies were included. Preoperative videostroboscopies were reviewed by a blinded reviewer. Multivariable logistic regression was used to examine the correlation between laryngoscopic appearance of glottic keratosis and presence or absence of high-grade dysplasia or carcinoma on biopsies. Consensus among head and neck cancer surgeons to detect specific laryngoscopic findings was evaluated by presenting representative laryngoscopies to a blinded cohort. Interrater reliability was calculated using Fleiss's κ. Sixty glottic keratotic lesions met inclusion criteria. On logistic regression, both erythroplakia and aberrant microvasculature like vascular speckling were significantly associated with high-grade dysplasia and carcinoma, = .002 and = .03, respectively. Interrater reliability among clinicians to identify erythroplakia and aberrant microvasculature was minimal, κ = 0.35 and κ = 0.29, respectively. Interrater reliability was improved with the use of virtual chromoendoscopy. The presence of erythroplakia and aberrant microvasculature in glottic keratosis is associated with the presence of high-grade dysplasia or carcinoma. Virtual chromoendoscopy can be used to improve reliability for detecting erythroplakia and vascular speckling, and this is a potential area for practice-based learning. Clinicians should identify and consider immediate diagnostic biopsy of suspicious glottic keratosis. |
Author | Anis, Mursalin M. Rosow, David E. Diaz, Jennylee Lloyd, Adam T. Patel, Mausam |
AuthorAffiliation | 2 University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA |
AuthorAffiliation_xml | – name: 2 University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA – name: 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34235372$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1288/00005537-199503001-00001 10.1002/hed.2880130604 10.1177/000348945306200206 10.1002/hed.25047 10.1001/jama.1946.02870490001001 10.1017/S0022215100061120 10.5858/arpa.2017-0438-RA 10.1002/lary.27585 10.1177/0194599813520123 10.1002/lary.25005 10.1080/00016489.2017.1347826 10.1177/000348940811700114 10.1371/journal.pone.0180590 10.1002/hed.23838 |
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Keywords | erythroplakia laryngeal cancer leukoplakia angiogenesis glottic keratosis |
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contributor: fullname: Chen M – ident: e_1_2_9_17_1 doi: 10.5858/arpa.2017-0438-RA – ident: e_1_2_9_6_1 doi: 10.1002/lary.27585 – volume: 7 start-page: 3305 issue: 10 year: 2014 ident: e_1_2_9_19_1 article-title: Clinical experiences of NBI laryngoscope in diagnosis of laryngeal lesions publication-title: Int J Clin Exp Med contributor: fullname: Xinmeng Q – ident: e_1_2_9_7_1 doi: 10.1177/0194599813520123 – ident: e_1_2_9_16_1 doi: 10.1002/lary.25005 – ident: e_1_2_9_10_1 doi: 10.1080/00016489.2017.1347826 – ident: e_1_2_9_18_1 doi: 10.1177/000348940811700114 – ident: e_1_2_9_11_1 doi: 10.1371/journal.pone.0180590 – ident: e_1_2_9_12_1 doi: 10.1002/hed.23838 – start-page: 340 volume-title: Methods and Applications of Statistics in Clinical Trials: Vol. 2. Planning, Analysis, and Inferential Methods ident: e_1_2_9_15_1 contributor: fullname: Gwet K |
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Snippet | Objective
Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after... Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after biopsy. We... Objective Glottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after... OBJECTIVEGlottic keratosis poses a challenge because a decision to biopsy must weigh the likelihood of dysplasia and cancer against the voice outcome after... |
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SubjectTerms | angiogenesis Biopsy Diagnostic tests Endoscopy erythroplakia glottic keratosis Health risks Laryngeal cancer Larynx leukoplakia Original Research |
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Title | Glottic Keratosis: Significance and Identification of Laryngoscopic Findings |
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