Reinke’s Oedema Causes, Symptoms, Treatment
Reinke’s oedema is an organic voice disorder caused by an accumulation of fluid in the most superficial layer of the lamina propria, a layered structure of the vocal fold. An organic voice disorder occurs due to changes to structures of the voice box (larynx) or the nerves that control voice production.
Reinke’s space is the outermost layer of the lamina propria, which comprises loose, pliable fibres. As such, Reinke’s oedema is classified as a type of organic voice disorder as changes occur at the level of the vocal folds (located in the larynx/voice box) due to this accumulation/build-up of fluid. Reinke’s oedema causes the vocal folds to bilaterally swell, almost occluding the airway.
Reinke’s oedema is mainly caused by phonotraumatic behaviours, which means behaviours that cause trauma to laryngeal health. These phonotruamatic behaviours occur as a result of vocal misuse and abuse; for example, through yelling, shouting, excessive drinking and/or smoking etc.
Other causes of Reinke’s oedema include hypothyroidism and gastroesophageal reflux. As a result of the accumulation of fluid at the level of the vocal folds, Reinke’s space becomes rigid and less flexible, therefore reducing vocal fold vibration.
Dysphonia is a term given to disorders of the voice. Essentially, the term dysphonia refers to the inability to produce sounds using the vocal organs. The most typical symptom associated with Reinke’s oedema is a lower than normal pitch.
Patients may also complain of shortness of breath as the vocal folds may partially block the airway as a result of the oedema. Increased vocal effort may be required to phonate/produce voice due to the accumulation of fluid at the level of the vocal folds. Other patients may experience changes to voice, which include a low-pitched, raspy or husky voice.
Reinke’s Oedema Treatment Strategies
Long-term success in the treatment of Reinke’s oedema involves various factors, as this particular voice disorder does not resolve on its own. The first course of treatment is to eliminate the underlying cause of the problem (i.e. stop smoking, treat reflux etc.). In some cases surgery may be an option to ensure some voice restoration. Speech therapy, however, is highly recommended to improve vocal quality and overall voice production.
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This article was written by our Speech Pathologist Eugene Pillay who is a Speech Pathology Australia member.
If you have questions about speech therapy for people with reinke’s oedema, contact your local doctor, who will arrange for you to see a speech pathologist. Contact us today!
Colton, R.H., & Casper, J.K. (1996). Understanding voice problems: A physiological perspective for diagnosis and treatment (2nd ed.). USA: Lippincott Williams & Wilkins.