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Objectives/hypothesis: The primary suspicion for glottic malignancy during office laryngoendoscopy is based on lesion appearance. Previous studies investigating laryngeal use of narrow band imaging (NBI) are mostly descriptive. The additive value of NBI relative to white light (WL) requires further investigation.Study Design: Observational matched study.Methods: NBI was compared with WL images of 45 vocal fold lesions suspected for malignancy (21 carcinoma, 22 dysplasia, two benign). All images were presented randomly and evaluated by six independent otolaryngology specialists. The observers were asked to estimate lesion size, location, and pathology. The results for the two imaging modalities were compared with each other and with the final pathology.Results: The observers estimated lesion size to be larger in the NBI images by an average of 9% (2.4 mm2 ; P =.04) compared to WL. In 64.6% of cases, the observers estimated similar pathology for NBI and WL. When there was a discrepancy, the estimated pathology was "malignant" in 24.3% by NBI, compared with 11.1% by WL. Overall, 44.7% of the lesions were estimated to be malignant by NBI, compared with 33.8% by WL (P =.001). The sensitivity and specificity rates for malignancy detection by NBI were 58.6% and 61.2%, respectively, compared to 48.7% and 76.1% by WL.Conclusions: Observers tend to estimate vocal fold lesions to be larger and more frequently suspect malignancy while assessing NBI images. Compared with WL, NBI demonstrates increased sensitivity and decreased specificity for detection of malignancy. Nevertheless, the specificity and sensitivity of NBI alone are considerably low.Level Of Evidence: 4 Laryngoscope, 127:894-899, 2017. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Gradual decrease in tube size and tube capping are considered the standard of care for tracheostomy decannulation. Both of these actions result in increased airway resistance. Immediate decannulation may offer a more tolerable approach.Objective: To assess the feasibility of immediate tracheostomy decannulation compared with the traditional decannulation methods.Methods: This study is a single institute, case-control retrospective study of patients between the years 2009 to 2014. The study group included all patients who underwent immediate decannulation, whereas the control group comprised patients who underwent traditional staged decannulation. An immediate decannulation protocol included admission to the intensive care unit, a comprehensive evaluation, decannulation, 24 hours of monitoring, and observation until discharge.Results: Twenty-nine patients were included in the study group and 20 in the control group. No significant statistical difference was found between the two groups in the patients' medical history and tracheostomy data, except for the Acute Physiology and Chronic Health Evaluation II score and duration of the deflated cuff, which were significantly higher in the control group. A significant difference was found in the complication rate between the groups. In the staged decannulation group, four patients failed decannulation and required reinsertion of the tracheostomy cannula, whereas there were no such failures in the immediate decannulation group. Hospitalization duration after decannulation of the study group patients was significantly shorter than that of the control group.Conclusion: Immediate decannulation may offer a safe alternative for weaning from tracheostomy. It may also reduce the duration of the weaning process and hospitalization.Level Of Evidence: 3b Laryngoscope, 126:2057-2062, 2016. [ABSTRACT FROM AUTHOR]