Reinke’s edema

Reinke’s edema is a thickening of the vocal folds with a deposit of a gelatinous substance. Reinke’s edema usually occurs on both vocal folds. The thickening causes the vocal folds to vibrate more slowly and irregularly during vocalization, resulting in a deep and harsh vocal sound. If a vocal function is disturbed by this, surgical treatment is required. Reinke’s edema is one of the common voice disorders.

If there is an indication for surgery, it is usually performed under general anesthesia. In the case of large bilateral edemas, two or more operations may be necessary. After professional removal of the edema, breathing and voice improve. The voice will no longer sounds so rough and strained. It usually becomes somewhat brighter, but the individual voice tone does not usually change significantly.

Reinke’s edema is characterized by abundant interstitial (betweeen cells) storage of a gelatinous mass directly under the surface membrane of the vocal fold (this area under the epithelium is called lamina propria or Reinke’s space). The additional mass of the vocal fold causes slower vibrations – the voice sounds rough and especially female voices may be perceived as male voices.

Reinke's edema

The development of edema is not fully understood. Women who are older than 30 and smoke are particularly often affected. As a rule, Reinke’s edema is not malignant, nor is it a precursor to malignant change. Very large edemas can also narrow the laryngeal inlet and cause breathing difficulties.

How to treat?

Once an edematous swelling is present it will not resolve or disappear again. Reinke’s edema mostly interferes significantly with speech and might cause frequent throat clearing. We recommend phonomicrosurgical removal with high-precision instruments. Alternatively, a photoangiolytic laser can be used in an office-based laser surgery procedure. In most cases after adequate treatment, the edema will not recur again. However, when smoking or reflux is still present, it might come back.

Remove gently with the laser

An alternative to surgery under general anesthesia is a new procedure using a photoangiolytic laser (KTP laser or Blue Laser), which can be used under local anesthesia. This laser scleroses the vessels inside the vocal fold so that the edema “dries up” after a few days. Usually it requires several (few) such laser surgeries. In the MEDICAL VOICE CENTER, as well as in the USA, laser therapy has almost become a routine procedure in the treatment of Reinke’s edema.