Objective: To investigate the correlation between the morphologic appearance of Reinke’s edema (RE) and disease regression following office-based blue laser therapy.
Methods: After obtaining IRB approval from the American University of Beirut Medical Center (IRB BIO ID: 2022-0280), the medical records and video recordings of all patients diagnosed with RE and who underwent office-based blue laser therapy at a tertiary referral center between November 2023 and October 2025 were reviewed. The RE lesions were categorized as polypoid or non-polypoid based on De Vincintiis classification. Procedure-related variables included procedure duration and total energy delivered. Disease regression was graded by two otolaryngologists who reviewed the video recordings of laryngeal endoscopy performed before and after surgery. Inter-rater reliability was computed to determine the consistency of the reported findings. The mean follow-up duration was 22.14 ± 24.74 weeks.
Results: A total of 21 patients, 15 females and 6 males were included in this study. The mean age of the study population was 56.24 ± 8.30 years. Fourteen patients had bilateral disease (66.7%). A total of 35 lesions, 15 polypoid and 20 non-polypoid, were examined. In the subgroup of patients with polypoid lesions, 7 regressed completely, 7 regressed partially, and 1 did not regress. In the subgroup of patients with non-polypoid lesions, 9 lesions regressed completely, 10 regressed partially, and 1 did not regress. There was no statistically significant difference in disease regression between the two subgroups (p=0.804, 0.629, 1.00 respectively). There was no correlation between lesion type (polypoid or non-polypoid) and disease regression (r=0.02; p=0.90). There was also no statistically significant difference in the duration of surgery or the number of Joules delivered between the two types of lesions.
Conclusion: The results of this investigation indicate that RE with a polypoid mass responded to blue laser therapy in an office setting similarly to RE without a polypoid mass. The morphology of RE did not have an impact on the extent of disease regression. A large prospective study accounting for confounding variables such as vocal hygiene and reflux disease is needed to further substantiate the results of this investigation.