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Overview | Understanding the Disorder | Symptoms | Diagnosis | Treatment
Key Glossary Terms
“Swelling in Reinke’s space”; a voice disorder caused by accumulation of gelatinous substance in Reinke’s space
Reinke’s Space (Superficial Lamina Propria)
Layer just underneath the surface lining of the vocal fold; composed of cells, special fibers, and other substances (extracellular matrix); has key role in vocal fold vibration
A “radical” surgical procedure that removes (“strips”) the top layers of the vocal folds resulting in severe vocal fold scarring and abnormal voice. Due to the resultant damage, this procedure is at present rarely used
Voice disorders can result from the swelling of the non-muscle part of the vocal fold that is right underneath its surface lining (i.e., in the superficial lamina propria, also known as Reinke’s space). This condition is called Reinke’s edema, which literally means “swelling in Reinke’s space” or “build-up of fluid in Reinke’s space.”
A change in a vocal fold causes change in vocal fold vibration. The vocal fold swelling makes the superficial lamina propria (Reinke’s space) stiff, thus reducing vocal fold vibration – hence voice changes and/or problems. (For more information, see Anatomy & Physiology of Voice Production.)
Patients usually have a low, raspy, or rough voice. A low voice is particularly striking in women – a male-quality voice in a female.
Reinke’s edema is caused by vocal fold irritation from voice misuse, smoking, and/or conditions that irritate the vocal folds, such as backflow of stomach fluids to the voice box (laryngopharyngeal reflux). Reinke’s edema typically occurs in middle-aged/post-menopausal women who have a long-term history of smoking cigarettes.
Reinke’s edema does not go away on its own.
The cause of Reinke’s edema needs to be identified and treated before treatments directed at the voice disorder (such as voice therapy or surgery) are considered.
Elements of Successful Treatment
Long-term success in the treatment of Reinke’s edema requires two, sometimes three approaches.
Fixing the underlying cause (e.g., stop smoking, treat reflux, eliminate voice overuse or abuse)
In some cases, vocal fold phonomicrosurgery (For more information, see Phonomicrosurgery.)
Although Reinke’s edema usually develops slowly over the course of many years, the condition can worsen to the point of causing problems with breathing (airway problems).
Any and all airway problems require immediate attention.
According to current best practices, there is no role for “vocal cord/vocal fold stripping” in treating Reinke’s edema. “Vocal cord/vocal fold stripping” refers to the removal of vocal fold epithelium using microcup forceps. This procedure results in excessive vocal fold scarring.
If primary causes, such as smoking or reflux, are not addressed, Reinke’s edema will recur.
Patient education material presented here does not substitute for medical consultation or examination, nor is this material intended to provide advice on the medical treatment appropriate to any specific circumstances.
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