{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:43:18Z","timestamp":1791931398904,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Currently, no classification system exists to grade the severity of supraglottic stenosis. The aim of this investigation was to (1) develop a novel grading system for supraglottic stenosis that can both enhance communication between providers and relay information about patient functional status and (2) determine the reliability of the grading system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of patients with supraglottic stenosis at three institutions from 2010\u20132021 was conducted. After demographic data were collected, two focus group meetings of five laryngologists were held to develop a grading system based on functional status and morphology of stenosis seen on laryngoscopy. Three laryngologists then used the grading system to rate 20 case examples of supraglottic stenosis. Quadratic\u2010weighted kappa coefficients were calculated to assess inter\u2010rater and intra\u2010rater reliabilities of the novel grading system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight patients were included. Epiglottic and arytenoid fixation were morphological features associated with worse functional outcomes such as requiring a G\u2010tube or a tracheostomy, respectively. Inter\u2010rater reliability was substantial to almost perfect (Kw\u00a0=\u00a00.79\u20130.81) and intra\u2010rater reliability was almost perfect for all raters (0.88\u20131.0) when using the novel grading system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A grading system for supraglottic stenosis has been proposed with strong inter\u2010rater and intra\u2010rater reliabilities. The proposed system has the advantage of being descriptive of both patient functionality and morphology of the stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3\u2014According to the Oxford Center for Evidence\u2010Based Medicine 2011 level of evidence guidelines, this non\u2010randomized retrospective cohort study is classified as level 3 evidence <jats:italic>Laryngoscope<\/jats:italic>, 133:1442\u20131447, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30371","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:09:37Z","timestamp":1662116977000},"page":"1442-1447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Novel Grading System for Supraglottic Stenosis Based on Morphology and Functional Status"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7701-7298","authenticated-orcid":false,"given":"Steven","family":"Aziz","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida  Tampa Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"O'Dell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Michael","family":"Johns","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health &amp; Science University  Portland Oregon U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al","family":"Merati","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Washington  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3139-8026","authenticated-orcid":false,"given":"Abdullah","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Washington  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-1977","authenticated-orcid":false,"given":"Stephanie","family":"Watts","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida  Tampa Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Garber","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York Medical College  Valhalla New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1635-8627","authenticated-orcid":false,"given":"Yael","family":"Bensoussan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida  Tampa Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0030-6665(20)30488-6"},{"key":"e_1_2_6_3_1","volume-title":"AJCC cancer staging manual","author":"Amin M","year":"2016"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000228006.21941.12"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941312200310"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2016.08.021"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.11613\/bm.2012.031"},{"key":"e_1_2_6_8_1","volume-title":"Intrarater reliability. 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