Reinke’s Edema

reinke_m_mediumReinke’s Edema is a polypoid degeneration of the true vocal cords.  Synonyms include Polypoid Corditis and Chronic Hypertrophic Laryngitis.  Reinke’s Space is a collection of loose gelatenous material in the superficial layer of the Lamina Propria between the non keritinizing stratus squamous epithelium of the true vocal cord and vocal ligament.  It is bounded anteriorly by Broyles ligamant and posteriorly by the arytenoids.
There is a strong association with smoking, vocal abuse and GERD.  These are fun people that you would want to hang around with. Some have mentioned hypothyroidism.
Treatment is smoking cessation, empiric treatment of LPR/GERD, and screening for thyroid issues.  Beyond that surgical intervention is warranted.  Hirono’s method is the creation of a superior true vocal cord incision and suctioning the excess gelatenous material out.  Laser and microdebrider techniques have been described.  Any excess flap then is trimmed with the micro laryngeal scissors.  I also like to add in a therapeutic steroid injection.