Question

Reinke's oedema.

Hint:

Smoking cessation and voice rest are key to managing Reinke's oedema, and surgical intervention may be required in more severe cases to restore normal voice function.

Answer 1

Step 1: Definition of Reinke's Oedema:
Reinke's oedema, also known as polypoid degeneration of the vocal cords, is a condition characterized by the accumulation of gelatinous fluid in the superficial layer of the lamina propria (Reinke's space) of the vocal cords. This condition causes swelling, leading to a low-pitched, husky voice, and is often associated with chronic irritation of the vocal cords.

Step 2: Causes of Reinke's Oedema:
The primary cause of Reinke's oedema is chronic irritation of the vocal cords. Common causes include:
1. Smoking: The most significant risk factor, as it causes chronic inflammation and damage to the vocal cords.
2. Voice Abuse: Overuse or misuse of the voice, such as excessive shouting or talking, can contribute to the development of the condition.
3. Gastroesophageal Reflux Disease (GERD): Chronic acid reflux can irritate the vocal cords, leading to the accumulation of fluid.
4. Environmental Irritants: Exposure to fumes, dust, or chemicals can also cause irritation of the vocal cords.

Step 3: Symptoms of Reinke's Oedema:
1. Hoarseness: The hallmark symptom of Reinke's oedema is a deep, husky, and rough voice, often described as "smoky."
2. Voice Fatigue: Individuals with Reinke's oedema may experience vocal fatigue after speaking or singing for long periods.
3. Airway Obstruction: In severe cases, the swelling of the vocal cords can lead to difficulty breathing and airway obstruction.

Step 4: Treatment Options:
1. Voice Rest: The first step in treatment is voice rest to reduce the irritation and swelling of the vocal cords.
2. Smoking Cessation: Quitting smoking is essential to prevent further damage and promote healing.
3. Surgical Treatment: If the oedema persists or is severe, surgical removal of the fluid or excision of the swelling may be necessary. This is often done using a microlaryngoscopic approach.
4. Voice Therapy: Speech therapy can help improve vocal technique and reduce strain on the vocal cords.