Reinke’s Edema and Hoarseness (in smokers ),is not a topic which gets a lot of attention. Apparently it’s still not a good idea to call the “spade” a spade.
But while Reinke’s edema occurs in both smokers and non smokers it is more common in the former.It’s also most likely to recur in smokers.
What exactly is Reinke’s edema?
It’s collection of fluids in a potential space called Reinke’s space.
This subepithelial space lying just below the epithelium of the vocal fold(this helps you speak and breathe) gers filled with a collection of fluids, making it to bulky and uneven.
Imagine a distorted bulky wire in a harmonium or guitar.The sound produced will be different from what is usual. Just like that in Reinke’s edema the voice change gradually worsens.
If you have a post nasal drip and habit of clearing throat ,it aggravated the problem.Professional voice users ,who are not taking care of their voice can also inadvertently cause such damage .
Main symptoms of Reinke’s edema
Voice quality changed
Hoarseness of voice
Range of voice diminished.
Others:
Difficulty breathing.Voice fatigue.
Who does it affect?What are the risk factors of Reinke’s Edema?
Smokers
Voice abusers
Those with LPRD/ reflux
The vocal fold vibrates to produce sound and our characteristic voice. When it becomes bulky the frequency of vibration changes, causing Hoarseness. When it becomes too heavy and swollen, it can even block the airway causing breathing difficulties.
What to do ?Management of Reinke’s edema.
Visit and consult ENT surgeon.
Diagnosis is by Indirect laryngoscopy
FOL/Fibreoptic laryngoscopy
Videostroboscopy
Diet and vocal hygiene are important.
Micro laryngeal surgery is done in case of severe cases. According to grades of damage, treatment varies.
Surgical management.:
Voice quality improves but is not as good as before. This is explained by preoperatively.
Explaining risk factors beforehand is crucial.
Remember:Smoking and reflux control is a must with or without surgical treatment.
Preoperatively few sessions of voice therapy helps patients get ready for post-op voice therapy with ease .
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Is there a role of steroids?
It’s not directly indicated for routine treatment of Reinke’s edema. But in the case of dyspnea, steroids may be given on a case to case basis, taking necessary precautions and explaining possible risks.
Will Reinke’s edema occur again?
Yes, it’s possible. If smoking, voice abuse, reflux is not strictly stopped, it can happen again .58%recurrence happens in those cases where the patient didn’t stop smoking.
Are you taking good care of your voice?Have a question related to ENT?Write to me at dramrita@healthwealthbridge.com.