Diagnosis
Reinkes edema
A benign disorder of the vocal folds defined by swelling of the superficial lamina propria (Reinke space) resulting in dysphonia.
Also known as: Chronic edema of vocal vord, Polypoid corditis, Polypoidal vocal cord, Pseudomyxomatous laryngitis, Smokers larynx
Etiology
Causes [rts][uun]
Cigarette smoking (and other local irritants)
Allergy
Infection
Vocal abuse
Laryngopharyngeal reflux
Pathophysiology
Chronic inflammation --> edema
Polypoid degeneration --> loss of pitch control and a rough voice
Yonekawa’s classification: [gap]
Type 1: Superficial edema of vocal folds without obstruction of the glottic lumen
Type 2: Edema extending to the posterior portion of the vocal folds
Type 3: Massive edema of the vocal folds that affects its entire length, a small glottic lumen remaining in the posterior region of the larynx
Risk factors [gap]
Women
Smokers
Complications [uun]
Airway obstruction
Epidemiology
Incidence per 100.000 [hub][rts][mfa]
Symptoms & findings
Symptoms
Aphonia, Dysphonia, Dyspnea, Hoarseness
Clinical findings
Anamneses
Localized findings
Approach
Laryngoscopy
Anamnesis: [uun]
Dysphonia
Duration
Onset
Inciting events
Associated symptoms (swallowing, dyspnea, throat pain, ear pain, hemoptysis)
Constitutional symptoms such as fever or weight loss
Modifying factors
Medical history
Smoking and alcohol use
Current medications
History of prior surgery or recent endotracheal intubation
History of prior radiation
Treatment
Conservative: [uun]
Smoking cessation
Voice rest
Speech therapy
Microsurgery: [gap][rts]
Microdebridement
Decortication
Laser therapy
Microflap
Injection of hyaluronidase
Intralesional steroid injection
Differential diagnoses
Acute laryngitis, Benign vocal cord lesion, Croup, Epiglottitis, Laryngeal cancer, Vocal cord immobility
References
[1] Dewan K, Chhetri DK, Hoffman H. Reinke's edema management and voice outcomes. Laryngoscope Investig Otolaryngol. 2022 Jun 17;7(4):1042-1050.
[2] Jones NN, Song SA. Reinke Edema. [Updated 2023 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK594275/
[3] Martins RHG, Tavares ELM, Pessin ABB. Are Vocal Alterations Caused by Smoking in Reinke's Edema in Women Entirely Reversible After Microsurgery and Smoking Cessation? J Voice. 2017 May;31(3):380.e11-380.e14.
[4] Pereira ER, Tavares EL, Martins RH. Voice Disorders in Teachers: Clinical, Videolaryngoscopical, and Vocal Aspects. J Voice. 2015 Sep;29(5):564-71.
[5] Dikkers FG, Nikkels PG. Benign lesions of the vocal folds: histopathology and phonotrauma. Ann Otol Rhinol Laryngol. 1995 Sep;104(9 Pt 1):698-703.