办公室蓝激光治疗Reinke水肿组织效应的拟议分类系统
Proposed Classification System for Office-based Blue Laser Tissue Effect in Reinke's Edema.
文献信息
| PMID | 42850127 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Abdul-Latif Hamdan |
| 作者单位 | Department of Otolaryngology - Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: ah77@aub.edu.lb. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 描述一种新的蓝激光诱导Reinke水肿（RE）组织效应的分类系统。
方法： 回顾了2022年10月至2026年5月期间接受办公室蓝激光治疗的RE患者的所有视频记录，共选取16个视频片段以涵盖观察到的不同类型组织效应。每个视频片段包括显示部分激光操作和即刻治疗后组织效应的短片段。汇编的视频记录由三位委员会认证的喉科医生根据拟议的4分分类法进行盲法评分；黏膜变白伴或不伴血管溶解（RE-BLL1）；黏膜变白伴上皮破坏或侵犯（RE-BLL2）；上皮破坏伴黏膜下组织消融/蒸发（RE-BLL3），以及上皮破坏伴黏膜下组织提取/移除（RE-BLL4）。
结果： 三位评审者之间的总体评分一致性为96.7%（60次评分中的58次）。RE-BLL1片段的评分一致性为100%（15次评分中的15次），RE-BLL2片段为93.3%（15次评分中的14次），RE-BLL3片段为93.3%（15次评分中的14次），RE-BLL4片段为100%（15次评分中的15次）。所有评审者对自己对未识别重复记录的分类均表现出100%的评审者内一致性。三位盲法评审者之间的评审者间信度极好。使用双向混合效应模型与绝对一致性，单次测量ICC为0.975（95% CI：0.948-0.989），表明单个评审者评分的信度极好。平均测量ICC为0.991（95% CI：0.982-0.996），表明当三位评审者的评分一起考虑时信度极好。
结论： 拟议的RE蓝激光治疗组织效应4分分类系统具有极好的评审者间和评审者内信度。通过标准化描述RE中蓝激光诱导的组织效应，该分类有助于改善喉科医生和其他嗓音护理提供者之间的一致沟通。
英文摘要
OBJECTIVE: To describe a new classification system for blue laser-induced tissue effect in Reinke's edema (RE).
METHOD: All video recordings of patients with RE who had undergone office-based blue laser therapy between October 2022 and May 2026 were reviewed, and a total of 16 video clips were selected to include the different types of tissue effects observed. Each video clip included a short segment showing part of the laser procedure and the immediate posttreatment tissue effect. The compiled video recordings were blindly rated by three board-certified laryngologists based on a 4-point proposed classification; Blanching of the mucosa with or without angiolysis (RE-BLL1); Blanching of the mucosa with epithelial disruption or violation (RE-BLL2); Epithelial disruption with submucosal tissue ablation/evaporation (RE-BLL3), and Epithelial disruption with submucosal tissue extraction/removal (RE-BLL4).
RESULTS: The overall agreement in rating among the three reviewers was 96.7% (58 of 60 ratings). The agreement in rating RE-BLL1 tokens was 100% (15 of 15 ratings), 93.3% for RE-BLL2 tokens (14 of 15 ratings), 93.3% for RE-BLL3 tokens (14 of 15 ratings), and 100% for RE-BLL4 tokens (15 of 15 ratings). All reviewers demonstrated 100% intra-rater agreement with their own classification of the unidentified repeated recordings. Inter-rater reliability among the three blinded reviewers was excellent. Using a two-way mixed-effects model with absolute agreement, the single-measure ICC was 0.975 (95% CI: 0.948-0.989), indicating excellent reliability of an individual reviewer's grading. The average-measure ICC was 0.991 (95% CI: 0.982-0.996), indicating excellent reliability when the three reviewers' scores were considered together.
CONCLUSION: The proposed 4-point classification system for tissue effects of blue laser treatment of RE had an excellent inter-rater and intra-rater reliability. By standardizing the description of the blue laser-induced tissue effect in RE, this classification could help improve consistent communication among laryngologists and other voice care providers.