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

Number of Access:1,881（2025-08-14 04:32 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/97773

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Title	Sex Differences in Predicting Difficult Laryngeal Exposure: Validation and Modification of Predictive Models
Creator	NRID 1000060625896 1000060625896 researchmap permalink drink drink Scopus Author ID 55914870000 55914870000 ORCID 0000-0002-5169-1038 0000-0002-5169-1038 CreatorName Hosokawa, Kiyohito
	CreatorName Nozawa, Masayuki
	CreatorName Otami, Yusuke
	ORCID 0009-0006-6551-2818 0009-0006-6551-2818 researchmap permalink itkktym itkktym CreatorName Kitayama, Itsuki
	CreatorName Hashida, Nao
	CreatorName Kawabe, Takanari
	CreatorName Aruga, Kenji
	NRID 1000000778631 1000000778631 researchmap permalink gam92471 gam92471 CreatorName Tsuda, Takeshi
	CreatorName Sato, Takashi
	NRID 1000000804379 1000000804379 CreatorName Tanaka, Hidenori
	NRID 1000020756944 1000020756944 researchmap permalink tk0513 tk0513 CreatorName Kishikawa, Toshihiro
	NRID 1000000636483 1000000636483 researchmap permalink entmaeda entmaeda CreatorName Maeda, Yohei
	NRID 1000040598398 1000040598398 ORCID 0000-0002-3135-5635 0000-0002-3135-5635 researchmap permalink yukinoritakenaka yukinoritakenaka Scopus Author ID 7102054128 7102054128 CreatorName Takenaka, Yukinori
	NRID 1000080403179 1000080403179 researchmap permalink mogawa-0731 mogawa-0731 CreatorName Ogawa, Makoto
	NRID 1000000273657 1000000273657 researchmap permalink read0046473 read0046473 Scopus Author ID 7004501837 7004501837 CreatorName Inohara, Hidenori
Subject	Difficult laryngeal exposure
	Laryngoscore
	Predictive models
	Sex differences
	Laryngeal microsurgery
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.
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.
Publisher	Elsevier BV
Source Title	Journal of Voice
Date of Issued	2024-08-24
Language	English
Handle URL	https://hdl.handle.net/11094/97773
PISSN	08921997
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1016/j.jvoice.2024.08.004
Access Rights	embargoed access
CopyRight	© 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/
CopyRight	The full-text file will be made open to the public on 24 August 2025 in accordance with the publisher's policy.
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
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	English
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	English
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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