ObjectiveTo explore the value of endoscopy in predicting the difficulties of glottic exposure and provide reference for preoperative evaluation.MethodsSeventy patients who underwent elective laryngeal microsurgical laryngeal lesions were included in the study, who were enrolled in Shenzhen Nanshan District Shekou People’s Hospital from January 2017 to October 2018. According to the situation of the glottis exposure, the patients with the difficulty of III/IV degree in glottis exposure were classified as the experimental group of the exposure difficulty; the patients with the difficulty of I/II degree were in the control group. The tongue plane score and the epiglottis upper edge score were observed in the glottis exposed group and the control group, and the Friedman tongue root grading was observed in the two groups. The correlations of tongue plane scoring, upper episode score, Friedman’s tongue grading, and glottic exposure difficulties was analyzed.Results6 cases of the 70 patients with the difficulty of glottic exposure during surgery, an incidence of 8.57%, were classified as the experimental group. 64 cases of the 70 patients did not have difficulty in glottic exposure and were classified as a control group. Corresponding to the using of 0°, 30° and 70° endoscopy, there were 8 cases, only 3 cases and 0 cases with a score of 1 to 3 points in the two groups respectively. According to III/IV degree of Friedman’s tongue root, there were a total of 23 cases in the control group, and 4 cases in the experimental group. Pearson correlation analysis, tongue plane score and upper episode score were negatively correlated to glottic exposure (P<0.05). Friedman’s tongue root grading was positively correlated to glottis exposure (P<0.05).ConclusionPreoperative measurement of the patient’s tongue plane score, upper episode score, and Friedman’s tongue root grading is of great significance in in predicting the difficulties of glottic exposure under laryngoscope.