Reinke's edema, also known as polypoid degeneration, is the swelling of the vocal folds due to fluid collection (edema

Edema

Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

).

Presentation

Reinke's edema causes the vocal folds to bilaterally swell giving them an uneven, sac-like appearance. Individuals with Reinke's Edema typically have low-pitched, husky voices.

Causes

Common causes of Reinke's edema include smoking

Tobacco smoking

Tobacco smoking is the practice where tobacco is burned and the resulting smoke is inhaled. The practice may have begun as early as 5000–3000 BCE. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes...

, gastroesophageal reflux

Gastroesophageal reflux disease

Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...

, hormonal changes such as hypothyroidism

Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...

 and chronic voice abuse.

Histology

Histopathology: biopsy

Biopsy

A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...

 of the vocal cord may be used to help in diagnosis in some cases. Histology shows oedema in the stroma.

Treatment

The first course of treatment is to remove the source of the irritant (e.g. smoking cessation, vocal rest, etc.). This can be effective if done soon after development of the edema. Surgery is also an option and can result in some restoration of the voice but is ineffective in complete restoration of the voice to its original state. Decortication of the vocal cords, i.e. removal of a strip of epithelium, is done first on one side and 3–4 weeks later on the other side.