Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 7, July, p. 865–871

doi: 10.17219/acem/116755

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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The assessment of phonatory and ventilatory functions in patients after microsurgery for Reinke’s edema

Katarzyna Ura-Sabat1,A,B,C,D, Joanna Morawska2,C,D, Wojciech Domka1,C,D, Marta Gamrot-Wrzoł3,C,D, Wojciech Scierski3,A,E, Ewa Niebudek-Bogusz2,A,F

1 Clinical Department of Otorhinolaryngology, Frederic Chopin Clinical Voivodeship Hospital No. 1, Rzeszów, Poland

2 Nofer Institute of Occupational Medicine, Department of Audiology and Phoniatrics, Łódź, Poland

3 Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia, Katowice, Poland


Background. Short and long-term results of microsurgical treatment with the mini-microflap technique in patients with Reinke’s edema (RE) were assessed based on the phonatory and ventilatory functions of the larynx.
Objectives. To assess the short and long-term results of microsurgical treatment with the mini-microflap technique in patients with RE based on the phonatory and ventilatory functions of the larynx.
Material and Methods. Twenty patients diagnosed with advanced stage of RE confirmed with laryngovideostroboscopy (LVS) were enrolled in the study. Phonatory function disturbances were additionally assessed on the basis of Maximum Phonation Time (MPT) measurement, Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-ROOL) questionnaires. Ventilatory function was assessed using spirometry. The aforementioned complex examinations were conducted prior to surgery and 1, 6 and 9 months following the surgery.
Results. Good postsurgical results were obtained in subjective and objective evaluation, which assessed the phonatory function and ventilatory parameters. Post-surgery increase in MPT, VHI and VQROL was noticed in all patients in 3 check points (p < 0.001). The results demonstrate postsurgical improvement for some LVS parameters, including assessment of glottis closure (p < 0.003) observed 6 months after the surgery. An improvement in most of the ventilation parameters was observed also 6 months after surgery (p < 0.001). For the spirometry flow parameter PEF, significant improvement was noted in each check point (p1 < 0.004, p6 < 0.001, p9 < 0.001). The study revealed a correlation between phonatory parameter – MPT and PEF observed 1 month after the procedure (p = 0.026), confirming the interdependence of ventilatory efficiency and phonatory condition of larynx.
Conclusion. Mini-microflap surgery brings satisfactory clinical effect in patients with advanced stages of RE by optimization of phonatory and ventilatory functions of the larynx.

Key words

spirometry, voice quality, long-term outcomes, mini-microflap surgery, Reinke’s edema

References (30)

  1. Rubin JS, Sataloff RT, Korovin GS. Diagnosis and Treatment of Voice Disorders. 4th ed. San Diego, CA: Plural Publishing Inc; 2014:95–105.
  2. Yonekawa H. A clinical study of Reinke’s edema. Auris Nasus Larynx. 1988;15(1):57–58.
  3. Tan M, Bryson P, Pitts C, Woo P, Benninger MP. Clinical grading of Reinke’s edema. Laryngoscope. 2017 Oct:127(10):2310–2313.
  4. Yonekawa H, Ohta F, Hirose H. Clinical classification of Reinke’s edema. Folia Phoniat Logoped. 1992;44:92.
  5. Siupsinskiene N, Skumaniene M. Phonatory characteristics follow-ing different endolaryngeal microsurgical techniques in Reinke’s disease [in Lithuanian]. Medicina (Kaunas). 2002;38(10):982–989.
  6. Kravos A, Hocevar-Boltezar I, Gersak K. Serum levels of sex hormones in males with Reinke’s edema. Eur Arch Otorhinolayngol. 2013;270(1):233–238.
  7. Niemczyk K, ed. Otolaryngologia kliniczna. Warszawa, Poland: Medipage; 2015:1547–1549.
  8. Szyfter W. Laryngologia. Poznań, Poland: Termedia; 2016:329–335.
  9. Obrębowski A. Narząd głosu i jego znaczenie w komunikacji społecznej. Poznań, Poland: Wydawnictwo Naukowe Uniwersytetu Medycznego w Poznaniu; 2008:15–18.
  10. Misiołek M, Niebudek-Bogusz E, Morawska J, Orecka B, Ścierski W, Lisowska G. Gender-related voice problems in transsexuals: Therapeutical demands. Endokrynol Pol. 2016;67(4):452–455.
  11. Martins RH, do Amaral HA, Tavares EL, Martins MG, Gonçalves TM, Dias NH. Voice disorders: Etiology and diagnosis. J Voice. 2016;30(6):761.e1-761.e9.
  12. Colton RH, Casper JK, Leonard R. Understanding Voice Problem: A Physiological Perspective for Diagnosis and Treatment. 4th ed. Philadelphia: Wolters Kluwer Health Adis (ESP); 2011:494.
  13. Yonekawa H, Nimii S, Hirose H. A follow up study of Reinke’s edema after surgery. In: Dejonckere PH, Peters HFM, eds. Communication and its Disorders: A Science in Progress. Proceedings of the 24th Congress IALP Asterdam, 1998, Nijmegen, the Netherlands: Nijmegen University Press; 1999:375–377.
  14. Dejonckere PH. Assessment of voice and respiratory function. In: Remacle M, Eckel H, eds. Surgery of Larynx and Trachea; 2nd ed. Berlin, Germany: Springer-Verlag; 2009:11–26.
  15. Tan NC, Pittore B, Puxeddu R. The ‚’M’’ shadep microflap for treatment of complex Reinke’s space edema of the vocal cords. Acta ­Otorhinolaryngol Ital. 2010;30(5):259–263.
  16. Druck G, Mauri M. Use of the microdebrider for Reinke’s edema surgery. Laryngoscope. 2000;110(12):2114–2116.
  17. Sommer C, Schults-Coulon HJ. Long-term results after microlaryngoscopic removal of Reinke’s edema [in German]. HNO. 2007;55(5):365–374.
  18. Rzepakowska A, Sielska-Badurek E, Osuch-Wojcikiewicz E, Niem­czyk K. Multiparametric assessment of voice quality and quality of life in patients undergoing microlaryngeal surgery: Correlation between subjective and objective methods. J Voice. 2018;32(2):257.e21–257.e30
  19. Niebudek-Bogusz E, Kopczynski B, Strumillo P, Morawska J, Wiktorowicz J, Sliwinska-Kowalska M. Quantitative assessment of video­laryngostroboscopic images in patients with glottic pathologies. Logoped Phoniatr Vocol. 2017;42(2):73–83.
  20. Caffier P, Schmidt B, Gross M, et al. A comparison of white light laryngostroboscopy versus autofluorescence endoscopy in the evaluation of vocal fold pathology. Laryngoscope. 2013;123(7):1729–1734.
  21. Young VN, Mallur PS, Wong AW, et al. Analysis of potassium tita­nyl phosphate laser settings and voice outcomes in the treatment of Reinke’s edema. Otol Rhinol Laryngol. 2015;124(3):216–220.
  22. Miller MR, Hankinson J, Brusasco V, et al; ATS/ERS Task Force. Standardisation of spiro­metry. Eur Respir J. 2005;26(2):319–338.
  23. Soner T, Melek KG, Ercan K, et al. The effect of surgical treatment on voice quality in Reinke’s edema: An evaluation with vocal performance questionnaire and acoustic voice analysis. J Med Updates. 2013;3(2):56–61.
  24. Lim JY, Choi JN, Kim KM, Choi HS. Voice analysis of patients with diverse types of Reinke’s edema and clinical use of electroglottographic measurements. Acta Otolaryngol. 2006;126(1):62–69.
  25. Bassel H, Olivier F, Teiga PS, Bouayed S, von Wihl S, Sandu K. Subjective voice assessment after endoscopic surgery for an obstructive Reinke edema using voice handicap index. Adv in Otolaryngol. 2015;2015:207085. doi:10.1155/2015/207085
  26. Misiołek M, Namysłowski G, Warmuziński K, Ziora D, Czecior E. Efficacy of laser arytenoidectomy in bilateral vocal cord paralysis. The review of the contemporary surgical procedures. Chir Pol. 2003;(5)2:91–96.
  27. Orecka B, Misiołek H, Namysłowski G, et al. Functional results after the treatment of laryngeal stenosis [in Polish]. Otolaryngol Pol. 2007;61(5):872–876.
  28. Harnisch W, Brosch S, Schmidt M, Hagen R. Breathing and voice quality after surgical treatment for bilateral vocal cord paralysis. Arch ­Otolaryngol Head Neck Surg. 2008;134(3):278–284.
  29. Swain SK, Sahu MC. Management of laryngeal airway in Reinke’s edema: An anesthetic overview. Int J Otorhinolaryngol Clin. 2017;9(1):35–37.
  30. Salmen T, Ermakova T, Schindler A, et al. Efficacy of microsurgery in Reinke’s edema evaluated by traditional voice assessment integrated with the Vocal Extent Measure (VEM). Acta Otorhinolaryngol Ital. 2018;38(3):194–203.