Reinke's Edema

Reinke’s edema, also referred to as polypoid corditis, occurs when polyps or swelling affects a structure known as the superficial lamina propria, which is essential for normal voice function. Although the edema is not considered pre-cancerous, it does indicate significant damage to the vocal cords. Patients with the condition should have their mouth, nose, and throat thoroughly examined to ensure that they do not have any precancerous lesions.

Who is at Risk for Reinke’s Edema?

Reinke’s edema typically occurs in smokers and is a result of the vocal cords being continually exposed to cigarette smoke. Although not as common, Reinke’s edema can also occur in individuals with severe acid reflux or who use their voice excessively.

Reinkes Edema UCI Head Neck 1 - Reinke's Edema
Reinkes Edema UCI Head Neck 2 - Reinke's Edema

Symptoms of Reinke’s Edema

As the superficial lamina propria swells and gains mass, it becomes boggy and does not vibrate as well. As a result, the voice can deepen significantly and become gravelly. Women tend to be diagnosed with the condition more often than men since the vocal changes are more noticeable. It is not unusual for women with Reinke’s edema to experience such profound changes in their voice that they are mistaken for men.

In some instances, the swelling can become so severe that it obstructs breathing. Initially, this may only be apparent during strenuous activity, but it can progress to the point that it interferes with breathing while at rest and even contribute to sleep apnea.

Diagnosing Reinke’s Edema

Reinke’s edema is characterized by swelling along the entire length of the vocal folds. The vocal folds may even take on an appearance similar to water balloons. The condition may be limited to one side, or it may affect the two vocal folds unevenly and appear to shift during breathing. The swelling may also only be noticeable when the patient breathes in sharply.

Treatments for Reinke’s Edema

Since the vast majority of cases of Reinke’s edema are the result of damage caused by smoking, the first step is to quit smoking. Depending on the extent of the damage, smoking cessation may be enough to allow some voice improvement and stop further progression of the condition. Even if further treatment is required, smoking cessation can significantly reduce the likelihood of recurrence.

For severe cases of Reinke’s edema, surgery may be necessary to reduce the superficial lamina propria. Traditionally, Reinke’s edema was treated by performing a direct laryngoscopy in which incisions were made in the vocal folds to remove the excess tissue. Today, microlaryngoscopy, a minimally invasive surgery using a laser, is a much more common technique. The procedure allows the excess tissue to be removed while still preserving normal vocal fold vibration. Most patients notice a substantial improvement in voice quality following surgery.

Reinkes Edema UCI Head Neck 3 - Reinke's Edema