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Objective: To assess interobserver agreement and intraobserver reproducibility when assessing the nasopharynx for malignancy under white light and narrow band imaging endoscopy because the decision to biopsy hinges on the examiner's perceived chance of malignancy., Methods: An interobserver and intraobserver agreement study utilizing white light and narrow band endoscopic images of the nasopharynx. The setting was an academic referral hospital. Participants were 156 adults with suspected nasopharyngeal carcinoma who underwent white light and narrow band imaging endoscopy and biopsy. Images of the nasopharynges were subsequently scored for malignancy by four otolaryngologists. The nasopharynx was scored on 4-point scales under white light and narrow band imaging endoscopy for the likelihood of malignancy or abnormality, respectively., Results: Intraclass correlation coefficients for intraobserver agreement for nasopharyngeal malignancy for four observers under white light were 0.86, 0.89, 0.79 and 0.88 (mean 0.855), respectively; and under narrow band imaging they were 0.64, 0.68, 0.64, and 0.66 (mean 0.655), respectively (all P values < 0.001). The coefficient for interobserver reliability under white light was 0.79 (95% confidence interval [CI] 0.76-0.82; P < 0.001), which indicated strong agreement. The coefficient for interobserver reliability under narrow band imaging was 0.56 (95% CI 0.50-0.61; P < 0.001), which indicated moderate agreement., Conclusions: Intraobserver and interobserver agreement for nasopharyngeal malignancy was strong on white light endoscopy but only moderate on narrow band imaging endoscopy. Agreement may be improved by adopting a standard set of assessment guidelines, including an objective detailed morphological analysis under white light and vasculature analysis under narrow band imaging., Level of Evidence: 2a Laryngoscope, 129:1374-1379, 2019., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

Aim The aim of the present study was to determine the accuracy of diagnostic sialendoscopy in patients with suspected obstructive salivary duct disease referenced to current imaging modalities. Patients and Methods A retrospective study of patients with symptoms suggestive of obstructive salivary duct disease who underwent one or more imaging modalities, and then sialendoscopy at an academic hospital, were reviewed. The radiological and sialendoscopic findings were compared, and the diagnostic accuracy of various imaging modalities was determined using sialendoscopy as a reference. Results Seventy-five sialendoscopies were performed in 68 patients (39 females, 29 males). Obstructive lesions were identified in 71 of the 75 sialendoscopies; 18 stones and 53 nonstone obstructive lesions were identified. Imaging consisting of plain X-ray ( n = 4), radiosialography ( n = 18), ultrasonography ( n = 58), computed tomography ( n = 13) and magnetic resonance imaging (n = 10) detected disease in 25, 70.6, 69.1, 69.2 and 100 per cent of diseased ducts, respectively. Conclusion Sialendoscopy is more sensitive, and thus more useful, in diagnosing obstructive salivary duct disease in symptomatic patients than current imaging modalities. Symptomatic patients with negative imaging should be considered for sialendoscopy when therapy, such as stone retrieval or stricture dilation, can instituted at the time of diagnosis. [ABSTRACT FROM AUTHOR]