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Exudative lesions of Reinke’s space
Reinke’s edema, polyps, nodules and pseudocysts of vocal folds
None of the diseases in Reinke’s space affects vocal ligament, the safety of which is a key element of normal voice formation. Properly performed surgery can render the voice to the man.
High-risk group includes smoking people living in conditions of air pollution, people who use their voice intensively. What is more, impaired nasal airflow can be the risk factor, as the dry air can get inside the larynx.
In addition, it was stated that the hyperthyroid affects the overload of the vocal apparatus. Anatomical anomalies, such as the sulcus of the vocal folds, small cicatricial webs in the anterior commissure and GERD do their parts. Combinations of all these factors lead to various macroscopic and microscopic manifestations: polyps, nodules, Reinke’s edema or pseudocysts.
For example, Reinke’s edema develops from cigarette smoking. Voice nodules are typically associated with voice overuse or misuse, so they are called singing. A combination of voice overuse and the presence of factors that reduce the resistance of the body, such as infections, allergies, endocrine diseases lead to polyps or pseudocysts formation. The dominant factor for the angiomatous polyp formation is the recent phonotrauma.
Hoarseness is the symptom that almost all voice disorders have in common.
Diagnostics and Treatment
A thorough otorhinolaryngologist’s examination is fundamental for the correct diagnosis and the choice of therapeutic approach. Endoscopy is the key standard for the examination. However, for differential diagnosis of the larynx diseases, stroboscopic examination is necessary as well.
During the surgical excision of diseases of Reinke’s space, the vocal cord should not be damaged. Only this way allows to achieve the expected result. What is more, the precise use of CO2 laser allows to be a step ahead.
In total, 980 benign laryngeal lesions have been removed by Professor Roberto Puxeddu.
Exudative lesions of Reinke’s space are polyps, nodules, Reinke’s edema and pseudocysts. The important characteristic which unites them all is their formation in the surperficial layer of the vocal fold, without the involvement of the vocal ligament itself. This fact explains the possibility and at the same time necessitates a conservative surgery, without reducing its effectiveness. Phonosurgical principles should be followed to achieve voice improvement or restoration. The surgery is performed under general anesthesia transorally, using a microscope and a CO2 laser.
Assistant Professor, Department of ear, nose and throat disease, Sechenov University, Moscow. ENT-specialist, health centre "Barviha" Presidential Affairs.
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