While this will not resolve or improve the edema, the cessation of smoking will halt the diseases progression.If the elimination of risk factors is not sufficient to improve the patients symptoms, surgery may be required. The most common type of surgery performed today for Reinkes edema is called surgical microlaryngoscopy. Most procedures follow the microflap technique set in place by Hirano. During surgery, an incision is made into the vocal cord using either microscissors or a CO2 laser. A flap of mucosa is lifted and the affected tissue is removed using suction or a microdebrider. The flap is then re-draped and trimmed to the appropriate size.Most cases of Reinkes Edema are bilateral - affecting both vocal cords - rather than unilateral. In the case of bilateral edema, the surgeon must choose whether to operate each side of the vocal cord in two separate surgeries or to operate both sides in a single surgery. The complication associated with removing tissue from both sides in a single surgery is that the raw, cut ends of the vocal cords may form an anterior glottis web, in which the two sides grow together in a continuous sheet. Other complications of surgery include tissue scarring due to damage to the vocal ligament during the incision and vocal cord stiffening due to over-suctioning of the superficial lamina propria (Reinkes space).While surgical microlaryngoscopy has its associated risks, if left untreated, Reinkes edema can lead to a variety of long-term complications.
Reinkes edema is the swelling of the vocal cords due to fluid (edema) collected within the Reinkes space. First identified by the German anatomist Friedrich B. Reinke in 1895, the Reinkes space is a gelatinous layer of the vocal cord located underneath the outer cells of the vocal cord. When a person speaks, the Reinkes space vibrates to allow for sound to be produced (phonation). The Reinkes space is sometimes referred to as the superficial lamina propria.Reinkes edema is characterized by the "sac-like" appearance of the fluid-filled vocal cords. The swelling of the vocal folds causes the voice to become deep and hoarse. Therefore, the major symptom of Reinkes edema is a hoarseness similar to laryngitis. The major cause associated with Reinkes edema is smoking. In fact, 97% of patients diagnosed with Reinkes edema are habitual smokers. Other identified risk factors include overuse of the vocal cords, gastroesophageal reflux, and hypothyroidism. The disease is more often cited in women than in men, because lower voice changes are more noticeable in women.The first cases of Reinkes edema were recorded in 1891 by M. Hajek, followed by F. Reinke in 1895. In his investigations, Reinke injected a stained glue into the superficial lamina propria (Reinkes space) to mimic edema. Reinkes edema is considered to be a benign (non-cancercous) polyp (protrusion) that represents 10% of all benign laryngeal pathologies. Treatment of Reinkes edema starts with the elimination of associated risk factors, such as smoking, gastric reflux, and hypothyroidism.