Reinke's oedema

Benign polypoid degeneration of one or both the vocal folds leading to dysphonia.Smoking is the commonest predisposing factor.

1. Reinke’s Edema Dr Shrikant Phatak Head of ENT Department Choithram Hospital & Research Center Indore

2. . Reinke’s space is a potential space of the true vocal cord bounded above and below by the junctions of squamous with respiratory epithelium, anteriorly by the anterior commissure, and posteriorly by the tip of the vocal process of the arytenoid . Edema  of this space is called  Reinke's edema

3. Reinke’s Edema Benign polypoid degeneration of the vocal cord. Can be unilateral or bilateral Commonest causative risk factors are 1.Smoking 2.Voice Abuse 3.Acid Reflux 4.Myxoedema Bilateral Reinki’s edema

4. Grades of Reinke’s Edema Grade1 –minimal polypoid change involving up to 25% of the membranous cord Grade2—Expanded polypoid lesion affecting 25—50% of the vocal cord Grade3 --Expanded polypoid lesion affecting 50-75% of the glottic airway Grade4—Obstructive lesion involving more than 75% of the glottic airway

5. Clinical Features Depend on the size of oedema . Edema is confined to the membranous vocal cord the commonest presenting feature is Dysphonia May or may not be associated Dyspnea & in rare cases Respiratory Distress

6. Stroboscopy Appearance Bilateral asymmetric oedema Unilateral oedema Oedema is best visualized during inspiration

7. Treatment Avoidance of risk factors Smoking Voice Abuse Riflux . I nhalational & oral steroids .

8. Surgical Treatment Indicated in case of no response to conservative treatment or when the oedema causes dyspnea. Aim is to excise redundant polypoid tissue & avoiding postop stiffening & a bad voice. Avoiding post op anterior web formation Surgery in selected cases.CO2 LASER, Microdebrider Cold instruments. Regardless of technique dysphonia improves but never normalizes.

9. Thank you

10. Disclaimer The information contained in the presentation is based on the personal experience and cases collected at Choithram Hospital Indore over the last 20 years. It is intended for the use of Medical students ENT post graduates. The views expressed are purely on personal opinion. viewers can make their own opinion. For any confusion please contact sole author. Everybody is allowed to copy or download the material best suited to him. I am not responsible for any controversies arising out of the presentation. For any suggestions or corrections you may please contact [email protected]