Comparison of a flexible laryngoscope with calibrated sizing function to intraoperative measurements

James B. Kobler, David I. Rosen, James A. Burns, Lee M. Akst, Matthew S. Broadhurst, Steven M. Zeitels, Robert E. Hillman

Research output: Contribution to journalArticlepeer-review


Objectives: The objectives were to assess the clinical performance and accuracy of a prototype fiberoptic transnasal laryngeal endoscope with an auxiliary optical system that allows images to be spatially calibrated. Methods: A novel fiberoptic endoscope was developed that projects green laser beams across the field of view from a separate optical channel. According to the location of the spots in the field of view, the images can be calibrated with a software routine. To assess its performance, we compared measurements of 14 lesions imaged with the calibrated endoscope and during microlaryngoscopy, where a calibration instrument was placed next to the lesions. Four clinicians measured lesion length, width, and area from the collected images. Results: The calibrated endoscope performed as well as current flexible fiberoptic laryngoscopes in terms of image quality and patient comfort. For lesions with well-defined borders, the error ranged from 14% to 23% for length, from 20% to 30% for width, and from 33% to 50% for area across observers. Factors contributing to larger errors in some subjects were identified. Conclusions: The calibrated endoscope is capable of providing useful sizing information for laryngeal structures, and these measures correspond quite well to more direct measurements in the operating room. Objective sizing of laryngeal lesions is complicated by subjective judgments of lesion boundaries, which can be indistinct in many cases.

Original languageEnglish (US)
Pages (from-to)733-740
Number of pages8
JournalAnnals of Otology, Rhinology and Laryngology
Issue number10
StatePublished - Oct 2006
Externally publishedYes


  • Calibration
  • Endoscope
  • Laryngology
  • Laryngoscopy
  • Optics
  • Videostroboscopy
  • Vocal fold

ASJC Scopus subject areas

  • Otorhinolaryngology


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