Hiroko Yonekawa

A Clinical Study of Reinke's Edema

A clinical study of 76 cases with Reinkes edema who underwent endolaryngeal microsurgery was carried out, and the postoperative results were evaluated. The patients were classified into three types: Type I, II, and III according to the severity of the disease as determined by laryngeal appearance. Postoperative changes in subjective symptoms were assessed and sound spectrographic and perceptual evaluations of voices were carried out before and after surgery in 38 cases. The majority of the patients were over 40 years of age for both sexes and most of the elderly patients were female. In Type III patients, the incidence was higher among females. All the patients complained of hoarseness and nine cases of Type III complained of dyspnea. Most of them had been chronically affected for over one year and showed a bilateral pathology. Smoking appeared to be the most dominant etiologic factor, while aging and a long history of vocal abuse also seemed to be causative factors. Improvement in subjective symptoms was found in almost all the patients treated with the squeezing technique proposed by the authors group. Improvement in voice quality was observed in acoustic evaluations. Among Type III females, it was often the case that the voice fundamental frequency was very low before surgery, while it increased markedly after surgery. In general, the voice after surgery showed less fluctuation in both pitch period and amplitude, as well as a smaller amount of noise components compared to that recorded before surgery. As measured by perceptual judgement, voice quality was found to be more improved in females than in males.