Asymmetric Reinke's edema.

A 51-year-old advertising agent with a 30-pack-year smoking history complained of dysphonia. She had been "hoarse" for a long time, but she hadn't sought treatment until she lost her voice during a "very social" vacation that involved a great deal of smoking, club dancing, and loud talking. Her voice had not returned to normal.

On examination, the patient's voice was diplophonic and deeper than normal. Strobovideolaryngoscopy revealed a large area of Reinke's edema on the right vocal fold and a more generalized edema of the left fold (figure).

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The patient was started on acid suppression therapy, and she was counseled to stop smoking and instructed on proper vocal technique by our voice team. A thyroid evaluation was normal.

If conservative measures fail to restore satisfactory vocal quality and endurance in patients with Reinke's edema, the swelling can be reduced by incising the epithelium, suctioning out the polypoid material, and conservatively resecting the redundant mucosa. Pulsed dye laser treatment may be helpful in some cases.

Robert Eller, MD; Mary Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA 

From the American Institute for Voice and Ear Research (Dr. Eller and Ms. Hawkshaw) and the Department of Otolaryngology--Head and Neck Surgery, Drexel University College of Medicine and Graduate Hospital (Dr. Sataloff), Philadelphia.