Reinke ‘s edema was discovered in 1895 by the anatomist Friedrich Reinke. The benign swelling of the vocal folds impairs speech. If Reinke’s edema is not chronic, simple measures such as resting your voice and not smoking or alcohol can help it to subside.
What is Reinke’s edema?
Reinke’s edema is tissue swelling of the vocal folds that leads to impairment of the vocal cords. The tissue water escaping from the capillary vessels collects under the mucous membrane. Reinke’s edema can be unilateral or bilateral. The thickening of the vocal cords results in restricted movement of the vocal folds in the airflow. For meanings of hyperdontia, please visit bestitude.com.
This leads to a hoarse voice (dysphonia). In extreme cases, it fails (aphonia) or slips in the pitch of the voice. Reinke’s edema mostly affects women between the ages of 40 and 60. It can appear as acute edema when, for example, the voice is briefly overloaded. In such a case, the watery, transparent swelling usually subsides a few hours later.
Inflamed edema is no longer transparent but reddened. If they are chronic and not surgically removed, nodules can form on the vocal folds, leading to voice loss.
How exactly Reinke’s edema develops is still unclear. However, risk factors are years of heavy smoking and excessive alcohol consumption. In addition, excessive or incorrect vocal strain (singer, teacher) is the cause. People who, for professional reasons, are exposed to fine dust, chemical vapors and other substances that irritate the respiratory tract for a longer period of time also have an increased risk of developing Reinke’s edema.
Recent clinical studies show that there may even be a hormonal connection between the storage of hyaluronic acid in the vocal fold epithelium and the development of Reinke’s edema. If the wrong breathing technique is used, the vocal cords are also put under additional strain. The influence of rising gastric acid (reflux) in the mouth and throat area has not yet been clarified. Excessively dry room air also makes things more difficult.
Symptoms, Ailments & Signs
Depending on the extent of the swelling, the swelling of the vocal folds causes a slightly rough to extremely hoarse voice. It is also sometimes deeper than usual. Prolonged speaking is perceived as too strenuous by those affected and is therefore often omitted. Severe edema can even lead to voice loss or the voice tipping over as in puberty.
If the glottis narrows even more, breathing problems (shortness of breath) are the result. It comes to reflux, increased mucus formation, frequent coughing, pressure and a lump in the throat. Since the voice flow is impeded by the narrowing of the glottis, patients with Reinke’s edema also have articulation difficulties. Sometimes the disease also appears as a symptom in the context of chronic non-specific laryngitis.
Diagnosis & course of disease
In Reinke’s edema, the cervical lymph nodes and the larynx are palpated to rule out a sore throat. A detailed examination of the mouth and throat and the vocal cords is then carried out using laryngeal endoscopy. Tissue removal (biopsy) is used to rule out other causes such as a granuloma, infiltration or malignant tumors.
Depending on the extent of the swelling, Reinke’s edema can lead to hoarseness or even loss of voice. Further narrowing of the glottis causes breathing problems such as shortness of breath and shortness of breath. In addition, increased mucus formation, whooping cough and the well-known lump in the throat can occur. The narrowing of the glottis often results in articulation difficulties.
If the disease occurs as a symptom of chronic, non-specific laryngitis, severe inflammation and acute shortness of breath can also occur. Persistent voice disorders cannot be ruled out, depending on the extent of the inflammation. If bacteria are the cause of laryngitis, the inflammation sometimes spreads further. This causes abscesses and phlegmon to form in the larynx. Severe pain and other complications often arise in connection with Reinke’s edema.
The treatment of Reinke’s edema via stripping results in visible scars. Bruising, hardening and occasionally also infections and wound healing disorders typically occur. In addition to these surgical risks, lymph or nerve injuries can also occur during stripping. If nerves are injured, this can lead to sensory disturbances. The globules Arum triphyllum 5 CH prescribed to accompany the procedure can cause mucosal inflammation if the wrong dosage is used.
When should you go to the doctor?
Reinke’s edema should always be treated by a doctor. Further symptoms can only be avoided by early diagnosis and treatment, so that the life expectancy of the person affected is not reduced. A doctor should be consulted for Reinke’s edema if the patient has a very hoarse or rough voice and can therefore only speak deeply.
In serious cases, there can also be a complete loss of voice, and some sufferers suffer a broken voice. Shortness of breath can also be a sign. Permanent heartburn can also indicate Reinke’s edema and should be examined by a doctor if the symptoms last longer and do not go away on their own.
First and foremost, Reinke’s edema can be examined and treated by an ENT doctor. In serious cases, however, preventive examinations for cancer are also useful in order to detect and treat them early. As a rule, the life expectancy of those affected is not negatively affected by Reinke’s edema and the disease progresses positively.
Treatment & Therapy
Severe chronic Reinke’s edema, in which breathing is also restricted, must be surgically removed. This is done with the help of stripping: the phonosurgeon removes the tissue swelling after local anesthesia or general anesthesia using tiny forceps or laser technology.
Only local anesthesia is more suitable, since the patient is still awake during the operation and his voice can then be better assessed: The vibration behavior of the vocal cord mucosa can then be checked stroboscopically. Whether the operation has brought the desired success can be seen at the earliest two to three months after the procedure, since only then is the wound healing process complete.
If both vocal folds are affected by the edema, the patient’s voice will not return to normal until the second has also been operated on. However, both vocal folds can only be operated on with the same anesthetic if the swelling is insignificant: otherwise they could grow together during the healing process. In the case of an operation performed under general anesthesia, the patient must remain in the hospital for three to six days.
After the surgical procedure, he should immediately undergo speech therapy to improve speech, breathing and posture. Acute cases of Reinke’s edema are treated by the ENT doctor with a spray containing cortisone. In addition, the person concerned should definitely quit smoking and also limit his alcohol consumption. The same applies to the time after the surgical intervention.
If the patient starts smoking or drinking alcohol again, the vocal folds will swell again. In general, the affected person should definitely rest their voice – regardless of whether they only have an acute or small chronic edema or have just had an operation. Minor swelling can even be treated homeopathically.
The patient takes 5 globules of Arum triphyllum 5 CH orally every hour. If the symptoms subside, the intake takes place at longer intervals and is discontinued when the symptoms have subsided. The patient should follow the dosage exactly, otherwise inflammation of the mucous membranes may occur.
Prevention for people who have to speak and sing a lot for work could be to drink a lot of fluids, only use their voice more often in warm rooms and always suck Emser salt pastilles in between. They should also not smoke and consume little alcohol.
You can do that yourself
Reinke’s edema usually has to be surgically removed. The vocal folds are irritated in the aftermath and must not be irritated by speaking or eating irritating foods. The patient should work out a suitable diet together with a nutritionist and the doctor in charge. The diet plan must be followed consistently to avoid irritation of the vocal cords.
At the same time, the triggers for the suffering must be eliminated. If the consumption of alcohol or cigarettes is the cause, these substances should be avoided. Small swellings can sometimes be treated homeopathically. It is best for the patient to contact an alternative health practitioner so that appropriate therapy can be initiated. For example, the Globuli Arum triphyllum C5 is effective, which can be used in consultation with the family doctorcan also be taken independently. As symptoms subside, the doctor-prescribed dose can be gradually reduced. The patient must strictly comply with the dosage. Otherwise, it can lead to mucosal inflammation, which is associated with significant health problems.
Reinke’s edema is not a serious condition, but it does require constant monitoring by a specialist. After completion of the initial treatment, regular follow-up checks are indicated. It is best for the patient to contact a specialist and inform them of any symptoms and complaints.
The extent to which follow-up care is necessary depends on whether the typical symptoms of Reinke’s edema can be completely resolved. If this is successful, no further treatments are necessary given the absence of symptoms. In all other cases, long-term treatment is necessary. In view of the threat of voice loss, medical support is particularly important in speaking professions.
In it, those affected learn how to deal with a wide variety of behaviors and exercises in order to prevent or reduce renewed fluid accumulation. You must do this on your own responsibility. The avoidance of fine dust and the cessation of smoking are essential. Patients also attend speech therapy sessions that help them avoid straining the vocal cords.
How long scheduled follow-up examinations are necessary and how intensive they have to be depends on the degree of the symptoms. The question of a unilateral and bilateral localization of the complaints also plays a role. In principle, the control also serves to discuss a surgical intervention. However, this is usually the last conceivable measure.
Doctors usually trust speech therapy therapies. They usually lead to the desired treatment success. As part of an examination, the pharynx is extensively inspected. The main focus is on the vocal cords, which are examined via laryngoscopy.