Structural Changes in Vocal Fold : Reinke's Edema/Polypoid Degeneration

Reinke's Edema/Polypoid Degeneration

Reinke's Edema and Reflux

Reinke’s edema occurs when the area known as Reinke's space becomes filled with viscous fluid due to long-standing trauma. In its most severe form, the entire membranous portion of the vocal folds become infiltrated with thick, gelatinous fluid, and gives them the appearance of enlarged, fluid-filled bags or balloons. This extreme form is called polypoid degeneration. Both Reinke’s edema and polypoid degeneration are caused by chronic vocal misuse of the laryngeal mechanism in conjunction with long-term vocal abuse and smoking.

Polypoid Degeneration

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Polypoid Degeneration

Unlike other laryngeal pathologies, Reinke's edema and polypoid degeneration tend to result in consistent changes in voice quality, including mild to moderate dysphonia (hoarseness), characterized by low pitch and a husky hoarseness. This voice quality has traditionally been described as a "whiskey" or “smoker’s” voice. Treatment for polypoid degeneration and Reinke's edema is usually surgical excision. Voice therapy is valuable both preoperatively in identifying the causes for the pathology and postoperatively for reestablishing good vocal hygiene and improved voice production.

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