{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:21:06Z","timestamp":1778854866345,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32DC000018"],"award-info":[{"award-number":["T32DC000018"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Current assessment techniques for determining whether a patient has normal interarytenoid anatomy, a deep interarytenoid notch, or a minor laryngeal cleft are highly variable. However, differentiating between these three entities is important, given it may distinguish whether a patient should be considered for surgical intervention. The Interarytenoid Assessment Protocol (IAAP) was developed to provide standardization of interarytenoid anatomy evaluations. We aimed to assess the reliability of the IAAP for assessment of interaytenoid mucosal height (IAMH) through a multi\u2010institutional validation study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Reliability of the IAAP was assessed by 10 pediatric otolaryngologists all from different academic centers. 30 de\u2010identified endoscopic videos of interarytenoid assessments were rated at two separate time points, 2\u2009months apart. Intra\u2010class correlation (ICC) coefficients with two\u2010way models were used to evaluate inter\u2010 and intra\u2010rater reliability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty endoscopic videos were collected for patients with a median (IQR) age of 4.9\u2009years (59\u2009months; range: 1\u2009month to 20\u2009years). On the first video assessment, inter\u2010rater reliability was 0.74 (95% CI 0.63\u20130.84), and on the second video assessment, inter\u2010rater reliability was 0.75 (95% CI 0.63\u20130.85) indicating strong inter\u2010rater reliability. Overall intra\u2010rater test\u2013retest reliability was 0.75 (95% CI 0.69\u20130.79) indicating strong agreement. In almost half, 14 (46.6%) raters chose IAAP classification levels within 1 level of each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Multi\u2010institutional validation of the IAAP demonstrates strong inter\u2010 and intra\u2010rater reliability for assessment of IAMH when evaluated through pictorial analysis. Standardization of anatomical evaluations may improve our ability to perform more reliable outcomes studies of pediatric pharyngeal dysphagia in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 135:1499\u20131505, 2025<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31866","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T07:45:16Z","timestamp":1731570316000},"page":"1499-1505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multi\u2010institutional Validation of the Interarytenoid Assessment Protocol for Pediatric Laryngeal Cleft"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1040-725X","authenticated-orcid":false,"given":"Jennifer M.","family":"Siu","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery The Hospital for Sick Children  Toronto Ontario U.S.A."},{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7947-4724","authenticated-orcid":false,"given":"Shaunak","family":"Amin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Seattle Children's Hospital  Seattle Washington U.S.A."},{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan J.","family":"Propst","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery The Hospital for Sick Children  Toronto Ontario U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5196-6150","authenticated-orcid":false,"given":"Nikolaus E.","family":"Wolter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery The Hospital for Sick Children  Toronto Ontario U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8123-2529","authenticated-orcid":false,"given":"Jeremy","family":"Prager","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Children's Hospital Colorado  Aurora Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Great Ormond Street Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Children's National Health Center  Washington DC U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5352-7469","authenticated-orcid":false,"given":"Douglas","family":"Sidell","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Stanford Pediatric Aerodigestive Center  Palo Alto California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Mehta","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery Texas Children's Hospital  Houston Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reema","family":"Padia","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; Neck Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery Children's of Alabama  Birmingham Alabama U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6409-7863","authenticated-orcid":false,"given":"Christopher","family":"Hartnick","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Massachusetts Eye and Ear  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9937","authenticated-orcid":false,"given":"Catherine K.","family":"Hart","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Cincinnati Children's Hospital University of Cincinnati College of Medicine  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology \u2013 Head &amp; 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