Establishing a Method for Measuring Laryngeal Prominence Size Using 2D Photography

For patients seeking chondrolaryngoplasty, little data exists on the visible differences between cisgender laryngeal prominences. This study aimed to establish a method for quantifying measurements of the laryngeal prominence in cis-females and -males using 2D photography to aid pre-operative counseling and surgical planning. A retrospective review of frontal and lateral photographs of cisgender adults from a facial plastics clinic at an academic center was conducted. A protocol was developed to measure length, area, maximum projection, and angle of the laryngeal prominence. Two fellowship-trained laryngologists identified the prominence, and three trained reviewers performed measurements. Inter- and intra-rater reliability was assessed. Mann-Whitney U tests assessed differences between male and female subjects. Spearman's correlation coefficient analyzed relationships between age, BMI, and measurements. Inter-rater reliability was good for prominence length (0.79), excellent for area (0.95) and maximum projection (0.98), and moderate for angle of prominence (0.72). Intra-rater reliability was excellent across all measures. Male and female measurements were significantly different (p < 0.001). In male subjects, the area of prominence (p = 0.003), maximum projection (p = 0.002), and angle (p = 0.001) negatively correlated with BMI. This study demonstrated a reliable, reproducible protocol for measuring the laryngeal prominence on lateral 2D photographs. Surgeons performing chondrolaryngoplasty can use photography to quantify thyroid notch anatomy effectively, aiding in surgical planning and tracking postoperative outcomes.