dataset · Zenodo (CERN European Organization for Nuclear Research)
Plain neck radiographs show a strong association with endoscopic severity in patients diagnosed with acquired laryngotracheal stenosis. In an evaluation of 119 patients aged 12 years and older, ordered airway calibre categories measured on anteroposterior and lateral neck radiographs strongly correlated inversely with endoscopic Cotton-Myer grades. Severe stages of stenosis, specifically grades three and four, were distinguishable from milder grades one and two using visible radiographic boundaries corresponding to a lumen of five millimetres or less, yielding sensitivity above 94 percent and specificity around 77 to 81 percent. However, discrimination specifically between grades two and three demonstrated lower accuracy. Because the evaluation relied exclusively on retrospective records of confirmed cases with categorical measurements and lacked reader-level data, the radiographic measurements cannot presently be used for standalone diagnosis, exact continuous threshold setting, or formal clinical triage.
Acquired laryngotracheal stenosis causes critical airway narrowing, which usually requires invasive endoscopy to accurately grade. Demonstrating that standard, non-invasive plain neck radiographs correlate with endoscopic severity provides an accessible method to estimate airway obstruction. This aids clinical understanding of radiographic capabilities, though current limitations prevent these images from replacing direct endoscopic examination or directing triage decisions without further validation.
The findings inform the development of non-invasive radiographic assessment protocols or diagnostic software tools for clinical radiologists and otolaryngologists managing established airway stenosis. However, the technology is at an early research stage. Because the retrospective data lacked reader consistency metrics, continuous measurements, and control groups, substantial prospective validation is required before these radiographic categories can be integrated into commercial triage algorithms or clinical diagnostic devices.
AI-generated from the published abstract. Always read the original work before citing.
Abstract Objective: To determine the association of anteroposterior (AP) and lateral neck radiographic airway categories with endoscopic Cotton-Myer severity in patients with confirmed acquired laryngotracheal stenosis (LTS). Methods: This retrospective cross-sectional study included patients aged 12 years or older with acquired nonmalignant LTS, a recorded Cotton-Myer grade, and paired AP and lateral radiographic entries (2005-2024). Airway caliber was stored as ordered categories (no detectable lumen, <5, 5, 10, 15, or 20 mm). Associations with grade were evaluated using Spearman correlation with bootstrap intervals. Within-disease discrimination of grades III-IV versus I-II was exploratory. Results: Of 175 database records, 119 met eligibility criteria. Grades I, II, III, and IV comprised 7, 24, 68, and 20 participants. AP and lateral categories were inversely correlated with grade (Spearman ρ, -0.862; 95% bootstrap CI, -0.912 to -0.794; and -0.858; 95% CI, -0.909 to -0.789). At the observable boundary comprising no detectable lumen, <5 mm, and 5 mm, AP counts were 85 true-positive, 7 false-positive, 3 false-negative, and 24 true-negative observations (sensitivity, 96.6%; lower-grade specificity, 77.4%; ordinal AUC, 0.932). Lateral counts were 83, 6, 5, and 25, respectively (sensitivity, 94.3%; specificity, 80.6%; AUC, 0.938). Grade II-versus-III AUCs were lower (AP, 0.886; lateral, 0.896). Conclusion: Ordered radiographic airway categories were strongly associated with endoscopic severity among patients already known to have LTS. The case-only design, categorical measurements, and absent reader-level data preclude claims of LTS diagnosis, an exact continuous threshold, or clinical triage. Keywords: acquired laryngotracheal stenosis; airway obstruction; Cotton-Myer grading; plain neck radiography; severity stratification
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.5281/zenodo.22082269
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
