Assessment of a Novel Tool for the Clinical Grading of Nasal Septal Perforation

被引：2

作者：

Miglani, Amar ^{[1
,3
]}

Rangel, India ^{[2
]}

Smith, Cody ^{[1
]}

Bansberg, Stephen ^{[1
]}

Lal, Devyani ^{[1
]}

Marino, Michael ^{[1
]}

机构：

[1] Mayo Clin, Dept Otorhinolaryngol Head & Neck Surg, Phoenix, AZ USA

[2] Mayo Clin, Alix Sch Med, Scottsdale, AZ USA

[3] Dept Otorhinolaryngol Head & Neck Surg, 5777 East Mayo Blvd, Phoenix, AZ 85054 USA

来源：

LARYNGOSCOPE | 2024年 / 134卷 / 07期

关键词：

edema; inflammation; nasal endoscopy; nasal septal perforation; objective assessment; RELIABILITY;

D O I：

10.1002/lary.31286

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

BackgroundNasal septal perforations (NSP) can have a heterogeneous appearance on endoscopic examination with varying degrees of crusting, inflammatory change, and associated septal deviation. The clinical applicability of these findings as contributors to patient symptoms may be enhanced by use of a standardized assessment.MethodsVideo nasal endoscopy recordings were obtained from 40 patients with NSP. Five raters with varied levels of training ranging from a senior resident to an experienced septal perforation surgeon independently reviewed the videos for the following exam findings: crusting, scarring, granulation tissue, septal deviation, and edema. Scoring for each item was reported on a 3-point (0-2) scale, and each reviewer repeated scoring at a 14-day interval. Interrater and intrarater agreement were calculated using Fleiss kappa for each item and the total scores. Additionally, endoscopy scores were correlated with patient-reported NOSE-Perf symptom scores.ResultsInterrater agreement for the overall instrument was in the "fair-to-moderate" range with the following interrater agreement for each item: crusting (0.458-0.575), scarring (0.286-0.308), granulation (0.403-0.406), deviation (0.487-0.494), and edema (0.253-0.406). Intrarater agreement was generally "substantial" for individual items as well as the overall instrument (0.688). The NSP endoscopy scores were moderately correlated with NOSE-Perf scores (r = 0.44, p = 0.008).ConclusionsAn endoscopic evaluation of NSP comprising five exam findings has acceptable interrater and intrarater reliability and correlates with patient-reported outcomes. NSP endoscopy may be applied to future clinical studies for characterization of NSP and assessment of treatment outcomes.Level of EvidenceLevel 3 Laryngoscope, 2024 We found that an endoscopic evaluation of NSP comprising five exam findings has acceptable interrater and intrarater reliability and correlates with patient-reported outcomes. NSP endoscopy may be applied to future clinical studies for characterization of NSP and assessment of treatment outcomes.image

引用

页码：3049 / 3053

页数：5