Reinkes edema is the accumulation of fluid in this space. Gere sunderplassmann, petra reinke, thomas rath, andrzej wiecek, michal nowicki, richard moore, jens lutz, martina gaggl, marek ferkl transpl int. Reinke s edema can also be treated in the office using laser. The entire length of the membranous vocal fold is edematous. Reinkes edema is the swelling of the vocal cords due to fluid edema collected within the reinkes space. Reinkes edema re is a benign polypoidal lesion of the vocal folds. This possibility in any case seemed unlikely in view of the preservation of the thyroid cartilage.
Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and. No significant relationship of reinkes oedema with hypotkyroidsm was found. Dynamic maneuvers in local staging of head and neck malignancies with current imaging techniques. The vocal folds show a white and translucent edema, confined into the superficial lamina propria.
We aim to propose and validate a clinical grading system based on size of the lesion to facilitate effective universal communication of disease severity. Indeed many ideas related to it should be questioned as the fact that mainly healthiest piglets are affected or that the colonization is limited to the intestine. The nonmuscle part of the vocal cord, sometimes called the vocal fold, right under its surface, is called reinke s space. The cause of reinke s edema is almost always smoking, which exposes the area of the throat that houses the vocal cords to the heat of inhaled cigarette smoke. Other confounders to identification of reinkes edema hypothyroidism reinkes edema can also be confused with voice disorder caused by low levels of thyroid hormone hypothyroidism. Clinical grading system for reinkes edema enttoday. Although reinke s edema is a common cause of substantial. Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. Gastroesophageal reflux and voice abuse may worsen this pathological condition but do not cause it. First identified by the german anatomist friedrich b. Pdf histological and electron microscopic investigation. Reinkes edema department of otolaryngology university. Officebased photoangiolytic laser treatment of reinke s edema ian j.
Reinke edema definition of reinke edema by medical. There were no dysplastic changes in the epithelium the treatment of reinkes oedema is a combination of surgery and vocal rehabilitation. Laser energy is then applied to a patients vocal folds. Reinke edema re is a gradually progressive swelling of vocal cord tissue. Reinke s edema is not itself a precancerous lesion, but it is a sign that the vocal cords have been exposed to a damaging degree of smoking. The rhine starts in basel, switzerland, and bends north through the german countryside until it reaches the north sea, passing through the cities of freiburg, frankfurt, bonn, and cologne. A case of reinkes edema causing difficult extubation. This file is licensed under the creative commons attributionshare alike 3. Here, with the vocal cords in abducted breathing position, one can only see somewhat underwhelming, broadbased, lowprofile swelling, along with some hazy leukoplakia in the midcord. The entire surface of the mouth, as well as the nose, throat and neck, should be carefully examined in people with reinke s edema to make sure no cancer or precancerous lesions have been overlooked. Since reinke s edema is a benign condition and since its treatment often involves difficult lifestyle changes, some individuals simply choose to live with its effects. Conventional microlaryngeal surgery is ideal for the treatment of reinkes oedema. Reinke s edema, also called polypoid chorditis, is a chronic accumulation of fluid in the subepithelial layer of the true vocal cord mucosa. Officebased photoangiolytic laser treatment of reinkes.
Edema disease is a paradoxal disease and is also a paradigmatic disease. A grade 1 lesions bilaterally with minimal polypoid degeneration. Histopathologic evaluation revealed reinke edema pseudocysts. Clinically, re is described as unilateral or bilateral swelling of the entire vocal. Local names are based upon the place where the original bearer lived or held land early origins of the reinke family. Oneyear followup results of combined use of co2 laser and cold instrumentation for reinke s edema surgery in professional voice users. A clinicopathological study of reinkes oedema springerlink.
Chronic irritation from smoking and acid reflux increases capillary permeability, leading to edema and polypoid degeneration of the true vocal cords. Reinke s edema re is a pathologically benign structural change of the vocal folds with a wide spectrum of clinical severity. When the vocal cords are impacted by the swelling, they cannot vibrate in the usual way. It most commonly presents as hoarseness and can complicate airway management during anesthesia and in the intensive care unit icu. The surname reinke is a local name, derived from the rhine river. Reinke s edema and nodules identification in vowels using spectral features and pitch jitter. It is comparatively common cause of voice disorder among middleaged population. B grade 2 bilateral lesions with expanded polypoid lesion occupying 25% to 50% of the glottic airway. It arose from a panel discussion at the aaohns meeting in 2000. Reinkes edema is the swelling of the vocal cords due to fluid edema collected within the. View at microlaryngoscopy demonstrating gross reinke s edema. Reinke edema finding on positron emission tomography. Reinkes edema prevents normal vocal cord vibrations, giving rise to a hoarse, lowpitched voice.
Reinkes edema prevents normal vocal cord vibrations. Swelling is usually bilateral and symmetrical, but can occur on one vocal fold more than the other. Smokers polyps reinkes edema 1 of 3 this patient is a longterm smoker, and also is talkative. Reinkes edema smokers voice treatment in manhattan. Reinke s edema with an instrument used to retract the left vocal fold. In reinke s edema, the entire length of the membranous vocal fold is filled with fluid swelling of reinke s space. The layer of tissue that covers the vocal fold inside. This causes the vocal cords to appear swollen and translucent image. In fact, surgery is mainly indicated when patients are sufficiently motivated to eliminate the cause or causes, such as quitting smoking. Reinke s edema is a benign lesion of the vocal folds, com monly seen among chronic smokers. Request pdf reinke edema the effect on quality of life qol of laryngectomy and organ preservation protocols is important in decision making. It involves the entire length of one or both vocal folds. The most frequent etiologic factor of reinke s edema is smoking.
This patient had bilateral reinkes edema, with mucosal swelling. Several histologic modifications are involved in this lesion, including modified stromal cell activity, microvasculature alteration with greater permeability, resulting in increased exudative fluid in the extracellular matrix, and disarrangement of. Reinke s edema is a benign lesion of vocal fold affecting subepithelial space. Studentresident case report poster critical care iii session type. The mechanism of the onset and development of the disease remains unclear 12. As with other conditions, the visual prognosis depends on the severity of the underlying condition, its duration, the general health. You may have seen an image of your swollen vocal folds during nasendoscopy. Longterm cigarette smoke exposure has been described as an etiological factor in a myriad of aberrant conditions of the vocal folds, including carcinoma, and a range of benign responses, including reinke edema re. Dailey, md otolaryngologyhead and neck surgery 2015 152. Reinkes edema jain s, varma r, hazarika b, pradhan s. Common causes of reinke edema include smoking, voice abuse, laryngopharyngeal refl ux, and hypothyroidism. Reinke s space causes changes in quality of vocal fold function, leading to pathological phenomena such as disphonia or dispnea. C grade 3 bilateral lesions occupying at least 50% of the glottic airway.
Academy of otolaryngologyhead and neck surgery aaohns and may reflect institutional preference andor bias. Pdf reinkes edema and nodules identification in vowels. Use of the microdebrider for reinkes edema surgery druck sant. Histological and electron microscopic investigation of. In contrast to polyps, reinke s edema results from smokingit is simply not found in.
He was born in ziethen a small town in the principality of ratzeburg and died in wiesbaden hessenassau, provinces of prussia. Clinical photographs of graded reinke s edema lesions. The median of three fo read from three sections was adopted as the final data fig. Discussion difficult airway is defined as difficulty in ventilation, intubation and laryngos. Find, read and cite all the research you need on researchgate. Pdf reinkes edema re is a benign polypoidal lesion of the vocal folds. Reinke in 1895, the reinkes space is a gelatinous layer of the vocal cord located underneath the outer cells of the vocal cord. For more information circle 110 on reader service card. The pathophysiology or mechanism of reinkes edema is not well known, however, chemicals contained within cigarette.
One of his siblings was johannes reinke a botanist and philosopher friedrich was educated at home until the age of 14, principally by his father and an aunt. Reinke s edema risk factors and causes women are more likely than men to get. An endoscope is placed to visualize a patients larynx. Macular edema is a common finding in many diseases of the retina, almost all of which can be treated to improve vision. Edematous swelling of the vocal cords can be easily recognized on indirect laryngoscopy, when the vocal cords are seen to be red and swollen and to have a slightly translucent appearance. Reinke s oedema occurs where the surface of the vocal folds fill with fluid, becoming swollen and distended. Though this condition rarely affects the vocal folds, the voicerelated complaints are similar to those of reinkes edema.
1010 880 1568 1539 922 776 1297 1222 998 95 943 1561 912 1127 1512 172 54 1575 1441 436 1169 6 396 675 409 110 1454 1589 1246 1354 1319 1142 1065 836 564 47 490