Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models

Hosokawa, Kiyohito; Nozawa, Masayuki; Otami, Yusuke; Kitayama, Itsuki; Hashida, Nao; Kawabe, Takanari; Aruga, Kenji; Tsuda, Takeshi; Sato, Takashi; Tanaka, Hidenori; Kishikawa, Toshihiro; Maeda, Yohei; Takenaka, Yukinori; Ogawa, Makoto; Inohara, Hidenori

doi:https://doi.org/10.1016/j.jvoice.2024.08.004

Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models

Hosokawa, Kiyohito; Nozawa, Masayuki; Otami, Yusuke et al.

Journal of Voice, 2024

アクセス数:96件（2025-05-16 16:41 集計）

固定URL: https://hdl.handle.net/11094/97773

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タイトル	Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models
著者	NRID 1000060625896 1000060625896 researchmap permalink drink drink Scopus Author ID 55914870000 55914870000 ORCID 0000-0002-5169-1038 0000-0002-5169-1038 著者名 Hosokawa, Kiyohito
	著者名 Nozawa, Masayuki
	著者名 Otami, Yusuke
	ORCID 0009-0006-6551-2818 0009-0006-6551-2818 researchmap permalink itkktym itkktym 著者名 Kitayama, Itsuki
	著者名 Hashida, Nao
	著者名 Kawabe, Takanari
	著者名 Aruga, Kenji
	NRID 1000000778631 1000000778631 researchmap permalink gam92471 gam92471 著者名 Tsuda, Takeshi
	著者名 Sato, Takashi
	NRID 1000000804379 1000000804379 著者名 Tanaka, Hidenori
	NRID 1000020756944 1000020756944 researchmap permalink tk0513 tk0513 著者名 Kishikawa, Toshihiro
	NRID 1000000636483 1000000636483 researchmap permalink entmaeda entmaeda 著者名 Maeda, Yohei
	NRID 1000040598398 1000040598398 ORCID 0000-0002-3135-5635 0000-0002-3135-5635 researchmap permalink yukinoritakenaka yukinoritakenaka Scopus Author ID 7102054128 7102054128 著者名 Takenaka, Yukinori
	NRID 1000080403179 1000080403179 researchmap permalink mogawa-0731 mogawa-0731 著者名 Ogawa, Makoto
	NRID 1000000273657 1000000273657 researchmap permalink read0046473 read0046473 Scopus Author ID 7004501837 7004501837 著者名 Inohara, Hidenori
キーワード等	Difficult laryngeal exposure
	Laryngoscore
	Predictive models
	Sex differences
	Laryngeal microsurgery
内容	Hosokawa Kiyohito, Nozawa Masayuki, Otami Yusuke, et al. Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models. Journal of Voice (2024); https://doi.org/10.1016/j.jvoice.2024.08.004.
抄録	Summary: Objectives/Hypothesis: To determine the presence of sex differences in difficult laryngeal ex-posure and the Laryngoscore, validate the Laryngoscore, mini-Laryngoscore, and Clarysse’s model for pre-dicting difficult laryngeal exposure, and modify the Laryngoscore for improved prediction accuracy. Study Design: Retrospective study. Methods: This study included 153 patients who underwent laryngeal microsurgery at a tertiary laryngology center and university hospital. Patients were evaluated using the 11 items of the Laryngoscore, mini- Laryngoscore, and Clarysse’s model to predict difficult laryngeal exposure. Difficult laryngeal exposure was defined as the inability to view the anterior commissure through a rigid laryngoscope under counterpressure to the anterior neck. Descriptive statistics and receiver-operating characteristic curve analysis were used to assess the diagnostic performance of the predictive models and variables, including sex. Results: The prevalence of difficult laryngeal exposure was significantly higher in men than in women, despite higher Laryngoscore values in females. The Laryngoscore, mini-Laryngoscore, and Clarysse’s model demon-strated good diagnostic performance with C-indexes of 0.751, 0.727, and 0.783, respectively. Based on these findings, we proposed a modified Laryngoscore, including treatment history, interincisors gap, upper jaw dental status, thyro-mental distance, degree of neck flexion-extension, and sex, achieving a C-index of 0.835. Conclusions: Inclusion of sex in the Laryngoscore and related predictive models enhances the accuracy of predicting difficult laryngeal exposure. These findings support the inclusion of sex as a factor in future mod-ifications of these models to improve their predictive performance.
出版者	Elsevier BV
収録物名	Journal of Voice
刊行年月	2024-08-24
言語	英語
ハンドルURL	https://hdl.handle.net/11094/97773
PISSN	08921997
関連情報 (isVersionOf)	DOI (出版社版) https://doi.org/10.1016/j.jvoice.2024.08.004
アクセス権	embargoed access
権利情報	© 2024. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
権利情報	The full-text file will be made open to the public on 24 August 2025 in accordance with the publisher's policy.
出版タイプ	Accepted Manuscript
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCTERMS.bibliographicCitation	Journal of Voice. 2024
DC.title	Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models
DC.creator	Hosokawa, Kiyohito
	Nozawa, Masayuki
	Otami, Yusuke
	Kitayama, Itsuki
	Hashida, Nao
	Kawabe, Takanari
	Aruga, Kenji
	Tsuda, Takeshi
	Sato, Takashi
	Tanaka, Hidenori
	Kishikawa, Toshihiro
	Maeda, Yohei
	Takenaka, Yukinori
	Ogawa, Makoto
	Inohara, Hidenori
DC.publisher	Elsevier BV
DC.language' scheme='DCTERMS.RFC1766	英語
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-08-24
DC.identifier	https://doi.org/10.1016/j.jvoice.2024.08.004
DC.subject	Difficult laryngeal exposure
	Laryngoscore
	Predictive models
	Sex differences
	Laryngeal microsurgery
DC.description	Hosokawa Kiyohito, Nozawa Masayuki, Otami Yusuke, et al. Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models. Journal of Voice (2024); https://doi.org/10.1016/j.jvoice.2024.08.004.
DCTERMS.abstract	Summary: Objectives/Hypothesis: To determine the presence of sex differences in difficult laryngeal ex-posure and the Laryngoscore, validate the Laryngoscore, mini-Laryngoscore, and Clarysse’s model for pre-dicting difficult laryngeal exposure, and modify the Laryngoscore for improved prediction accuracy. Study Design: Retrospective study. Methods: This study included 153 patients who underwent laryngeal microsurgery at a tertiary laryngology center and university hospital. Patients were evaluated using the 11 items of the Laryngoscore, mini- Laryngoscore, and Clarysse’s model to predict difficult laryngeal exposure. Difficult laryngeal exposure was defined as the inability to view the anterior commissure through a rigid laryngoscope under counterpressure to the anterior neck. Descriptive statistics and receiver-operating characteristic curve analysis were used to assess the diagnostic performance of the predictive models and variables, including sex. Results: The prevalence of difficult laryngeal exposure was significantly higher in men than in women, despite higher Laryngoscore values in females. The Laryngoscore, mini-Laryngoscore, and Clarysse’s model demon-strated good diagnostic performance with C-indexes of 0.751, 0.727, and 0.783, respectively. Based on these findings, we proposed a modified Laryngoscore, including treatment history, interincisors gap, upper jaw dental status, thyro-mental distance, degree of neck flexion-extension, and sex, achieving a C-index of 0.835. Conclusions: Inclusion of sex in the Laryngoscore and related predictive models enhances the accuracy of predicting difficult laryngeal exposure. These findings support the inclusion of sex as a factor in future mod-ifications of these models to improve their predictive performance.
DC.rights	© 2024. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
DC.rights	The full-text file will be made open to the public on 24 August 2025 in accordance with the publisher's policy.
DC.format	97773
citation_title	Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models
citation_author	Hosokawa, Kiyohito
	Nozawa, Masayuki
	Otami, Yusuke
	Kitayama, Itsuki
	Hashida, Nao
	Kawabe, Takanari
	Aruga, Kenji
	Tsuda, Takeshi
	Sato, Takashi
	Tanaka, Hidenori
	Kishikawa, Toshihiro
	Maeda, Yohei
	Takenaka, Yukinori
	Ogawa, Makoto
	Inohara, Hidenori
citation_publisher	Elsevier BV
citation_language	英語
citation_date	2024-08-24
citation_journal_title	Journal of Voice
citation_doi	https://doi.org/10.1016/j.jvoice.2024.08.004
citation_public_url	https://hdl.handle.net/11094/97773

Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models

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