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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(01): e77-e82
DOI: 10.1055/s-0042-1743463
Original Research

Reinke Edema: Factors that Interfere with Vocal Recovery after Surgery

José Luiz Lima Neto 
1   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Universidade Estadual Paulista Julio de Mesquita Filho, Unesp Botucatu, São Paulo, Brazil
,
Antônio Rodrigues Bueno da Fonseca 
1   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Universidade Estadual Paulista Julio de Mesquita Filho, Unesp Botucatu, São Paulo, Brazil
,
Elaine Lara Mendes Tavares 
1   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Universidade Estadual Paulista Julio de Mesquita Filho, Unesp Botucatu, São Paulo, Brazil
,
Andrea Cristina Joia Gramuglia 
1   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Universidade Estadual Paulista Julio de Mesquita Filho, Unesp Botucatu, São Paulo, Brazil
,
Regina Helena Garcia Martins 
1   Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Universidade Estadual Paulista Julio de Mesquita Filho, Unesp Botucatu, São Paulo, Brazil
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Abstract

Introduction Dysphonia and lower pitch after surgery of Reinke edema are common. They are caused especially due to chronic smoking but, probably, other factors should be associated.

Objectives To evaluate the results of laryngeal microsurgery in patients with Reinke edema, following a standardized postoperative guidance protocol in our service.

Methods Retrospective study. Thirty patients (3 males; 27 females) were included, 70% between 41 and 60 years old. The parameters analyzed in the pre- and postoperative (between 4 and 6 months) of patients undergoing laryngeal microsurgery for Reinke edema were: smoking, vocal symptoms, videolaryngostroboscopy, voice therapy, perceptual and acoustic vocal evaluation, histopathological report.

Results Smoking was reported by 100% of the patients and maintained in the postoperative period by 80%. Complete improvement of symptoms in the postoperative period was reported by 43% of them, partial improvement by 40%, and maintenance by 17%.

There was low adherence to voice therapy in the pre- and postsurgery.

Postoperative videolaryngoscopy indicated congestion (19), atrophy and bowed vocal fold (1), subepithelial edema (2), and normal findings (8). The histological findings were subepithelial edema, enlargement of vessels, inflammation, epithelial hyperplasia, and thickening of the basement membrane. The perceptual and acoustic vocal analyzes indicated improvement of the analyzed parameters.

Conclusions The maintenance of some vocal symptoms and laryngeal alterations in videolaryngoscopy after microsurgery of Reinke edema is frequent, even in patients who follow the recommendations of vocal rest and control of gastroesophageal reflux. Vocal symptoms are attributed to changes in the laryngeal mucosa caused by chronic smoking, aggravated by the maintenance of addiction in the postoperative period.

Keywords

reinke edema - dysphonia - surgery - treatment

Financial Support

None.




Publication History

Received: 24 September 2021

Accepted: 01 December 2021

Article published online:
27 September 2022

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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