Interrater reliability of sleep videofluoroscopy for airway obstruction in obstructive sleep apnea

Authors

  • Dong-Kyu Kim MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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  • Woo-Hyun Lee MD,

    1. Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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  • Chul Hee Lee MD,

    1. Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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  • Chae Seo Rhee MD,

    1. Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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  • Jeong-Whun Kim MD

    Corresponding author
    1. Departments of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
    • Send correspondence to Jeong-Whun Kim, MD, PhD, Associate Professor, Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Goomi-ro, Bundang-gu, Seongnam, 463–707, South Korea. E-mail: kimemail@naver.com

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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

Sleep videofluoroscopy (SVF) has been introduced to identify upper airway obstruction. This study was aimed to determine the interrater reliability of SVF in patients with obstructive sleep apnea (OSA).

Study Design

A retrospective analysis.

Methods

On the basis of apnea-hypopnea index in full-night attended polysomnography, 374 consecutive OSA patients who underwent SVF were enrolled in this study. The SVF was evaluated by three independent reviewers. Interrater reliabilities were assessed by evaluating agreement of the obstructive anatomic structures (soft palate, tongue base, tonsils, and epiglottis) and airway levels (velopharynx, oropharynx, and hypopharynx) between the reviewers.

Results

In a comparison between an unblinded and a blinded well-experienced sleep surgeons, the interrater reliability for the presence of obstruction was the highest for the soft palate at the level of the velopharynx (Cohen's kappa value, 0.919) and the lowest for the soft palate at the level of the oropharynx (Cohen's kappa value, 0.757). In a blind comparison between a well-experienced and less-experienced sleep surgeons, the interrater reliability for the presence of obstruction was also the highest for the soft palate at the level of the velopharynx (Cohen's kappa value, 0.938) and the lowest for the palatine tonsils at the level of the oropharynx (Cohen's kappa value, 0.635).

Conclusion

This study showed that SVF was a diagnostic modality that can be used to evaluate upper airway obstruction without significant interrater disagreements.

Level of Evidence

4. Laryngoscope, 124:1267–1271, 2014

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