page_title: Reinke's edema
section_title: Diagnosis
hierarchical_section_title: Reinke's edema / Diagnosis
caption_attribution_description: English: Laryngoscope
context_page_description: Reinke's edema is the swelling of the vocal cords due to fluid collected within the Reinke's space. First identified by the German anatomist Friedrich B. Reinke in 1895, the Reinke's space is a gelatinous layer of the vocal cord located underneath the outer cells of the vocal cord. When a person speaks, the Reinke's space vibrates to allow for sound to be produced. The Reinke's space is sometimes referred to as the superficial lamina propria.
  Reinke's edema is characterized by the "sac-like" appearance of the fluid-filled vocal cords. The swelling of the vocal folds causes the voice to become deep and hoarse. Therefore, the major symptom of Reinke's edema is a hoarseness similar to laryngitis. The major cause associated with Reinke's edema is smoking. In fact, 97% of patients diagnosed with Reinke's edema are habitual smokers. Other identified risk factors include overuse of the vocal cords, gastroesophageal reflux, and hypothyroidism. The disease is more often cited in women than in men, because lower voice changes are more noticeable in women.
  The first cases of Reinke's edema were recorded in 1891 by M. Hajek, followed by F. Reinke in 1895.
context_section_description: Reinke's edema is often diagnosed by an Ear, Nose & Throat (ENT) specialist or an Otolaryngologist by examination of the vocal cords. First, the doctor will review the patient's medical history and symptoms, such as hoarseness, dysphonia, and reduced vocal range. There is no familial or hereditary link to Reinke's edema. Because Reinke's edema is linked heavily to smoking, the doctor will need to know if the patient is a habitual smoker. Once the patient's history is reviewed, the vocal cords will be visualized using laryngoscopy, a technique in which a tube with a camera (endoscope) is passed through the nose and down the larynx.  Laryngoscopes can be rigid or flexible.  Flexible laryngoscopes, such as fiber laryngoscopes, allow the patient to produce sound as the tube is placed, and therefore allows the doctor to visualize movement of the vocal cord. The use of rigid laryngoscopes generally requires general anaesthesia due to the discomfort involved in distracting the soft tissues of the mouth and pharynx.
  Based on the results of the laryngoscopy, Reinke's edema can be classified using a standardized system set in place by Yonekawa. This system characterizes the disease based disease severity.
  Yonekawa Classification:
  Grade I – Lesions contact the anterior third of the vocal fold
  Grade II – Lesions contact the anterior two-thirds of the vocal fold
  Grade III – Lesions contact the entirety of the vocal fold
  If further evaluation is needed, stroboscopy is used to examine mucosal waves of the vocal cords.  Mucosal waves describe the waves produced by vibration of the vocal cords during speech.  Stroboscopes produce flashes of light that are timed to the patient's vocal frequency.  Every time the light is flashed, it will create a still frame image of the vocal cords at that particular moment in time.  These are combined to produce an image of the wave. In the case of Reinke's edema, structural changes to the vocal cords will result in abnormal wave patterns.
caption: Rigid laryngoscope instrument
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