Hong Jung SPHSC 100 Voice Disorder Report

Reinkes edema is a functional voice disorder that occurs when the superficial lamina propria, also called the Reinkes Space, swells up, which greatly obstructs speech. Vocal folds with Reinkes edema can be described as looking like water balloons due to the swelling. The edema can be on both sides of the vocal fold, or even just one. Because the vocal folds gain mass due to swelling, the vibration for phonation occurs in a lower frequency than normal, which causes the voice to become low and raspy. Most noticeable symptoms include persistent hoarseness and loss of voice brilliance. Other less common symptoms include vocal fatigue, voice pitch contraction, difficulty speaking softly, neck tightness, and noisy breathing. If the swelling is severe enough, the edema can also greatly impair breathing and cause shortness of breath. The swelling is caused due to the build-up of gelatinous fluid that occurs when the region is exposed to chronic inflammation. The source of irritation usually comes in three forms: smoking, voice abuse, and laryngopharyngeal reflux. The most common cause of Reinkes edema is smoking. The vocal folds are very sensitive to any irritation and smoke is an especially potent irritant. There are also some who claim that the edema is a reaction to the heat from inhaling smoke. Another form of irritation is misuse of voice. Reinkes edema can be caused by constantly overusing the vocal folds. Acid reflux can also cause the formation of edema, and is also responsible for a myriad of

other voice disorders (reflux laryngitis). There are other speculated causes of Reinkes edema which include genetics and allergic reactions. To treat Reinkes edema, the first step is to stop the source of irritation. In smokers, it is absolutely important to quit smoking because even with surgery, continued smoking will almost always allow the symptoms to return. Oftentimes, speech therapy is prescribed to encourage the proper use of the voice. For acid reflux, medication is prescribed. In some cases, surgery is recommended, using microsurgical techniques. The surgery consists of creating an incision on the vocal folds to drain the thick fluid build-up in Reinkes space. This process is usually tricky since the cut must be minimal on the superficial lamina propria to minimize scarring, because too much scarring produces hoarseness in the voice that is very difficult to fix. This is another reason why it is so pertinent for smokers to quit smoking. The demographic in which the Reinkes edema is found most commonly is for patients between the age of 40 to 60. But because the disorder is gradual, newly diagnosed patients have been experiencing fluid build-up in their vocal folds for years before seeking treatment. Because the difference in pitch is more noticeable in women than in men, more women tend to seek treatment for Reinkes edema even though about the same number of men have developed the condition. As mentioned above, those who are diagnosed are almost always smokers. When a smoker is diagnosed with Reinkes edema, physicians will check the mouth, the nose, and the throat to make sure that they have not missed any signs of cancer, which is also caused by smoking.

Many who have Reinkes edema often times do not want treatment since they do not want to give up smoking. This is seen primarily in those who have whiskey or smokers voice. Another reason for this is that the condition is benign and does not necessarily mean cancer, even if caused by smoking. But left alone, the edema can continuously increase in size and eventually cause respiratory problems. Treatment can vary from simply quitting smoking to microsurgical processes, and seeking medical care at the first sign reduces complication to the speech production, such as scarring. Therefore, like many voice disorders, seeking treatment, even for males, is definitely recommended for healthy voice production.

Works Cited "Symptoms of Reinke's Edema." Voice Foundation. The Voice Foundation, n.d. Web. 10 May 2013. <http://www.voicefoundation.org/index.php?option=com_content>. "Vocal Fold Nodules, Cysts, and Reinke's Edema." Vocal Fold Nodules, Cysts, and Reinke's Edema. N.p., n.d. Web. 10 May 2013. <http://www.evmsent.org/cysts_or_polyps.asp>. "Voiceproblem.org: Reinke's Edema: Treatment." Voiceproblem.org: Reinke's Edema: Treatment. N.p., n.d. Web. 10 May 2013. <http://www.voiceproblem.org/disorders/reinkesedema/treatment.php>.