Fig. 1. Laryngoscopic findings according to Yonekawa Fig. 2. possible etiologic factors. 2A Smoking, 2B Gastroesophageal reflux symptom, 2C Skin
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1 KISEP Head and Neck Korean J Otolaryngol 2000;43:873-7 라인케부종의원인및음성학적고찰 안중호 남순열 Possible Etiology and Voice Analysis of Reinke s Edema Joong Ho Ahn, MD and Soon-Yuhl Nam, MD Department of Otolaryngology, University of Ulsan, College of Medicine, Seoul, Korea ABSTRACT BackgroundReinkes edema is characterized by swelling of the vocal folds, and its etiology and pathogenesis have not yet been established. Objects and MethodsWe reviewed medical records of 25 patients 14 male and 11 female who had undergone operation from 1996 to Post-operative voice lab and skin prick tests were done after 3 months when patients visited hospital. Telephone questionnaires were carried out about smoking and laryngopharyngeal reflux. ResultsIn the smoking pattern, most patients 18/25 smoked more than 10 packs a year. Twelve patients 48 complained of laryngopharyngeal reflux symptoms and 4 patients were positive for the skin prick test. Pre- and post-operative voice lab results showed that shimmer and phonation time changed significantly in women patients. Jitter, shimmer, phonation time, mean flow rate, vocal efficiency and subglottic pressure changed significantly in men patients. ConclusionSmoking and laryngopharyngeal reflux may play an important role in developing Reinkes edema and phonatory quality will be improved after proper surgical procedure. Korean J Otolaryngol 2000;43:873-7 KEY WORDSLaryngeal edema Voice analysis. 873
2 Fig. 1. Laryngoscopic findings according to Yonekawa Fig. 2. possible etiologic factors. 2A Smoking, 2B Gastroesophageal reflux symptom, 2C Skin prick test for allergy. Table 1. Mean values of voice parameters Male n14 Female n11 Preop Postop p-value Preop Postop p-value Fo Hz Jitter % * Shimmer % * * NHR MPT sec * * MFR ml/sec * * Psub cm/h2o * Ve ppm * CQ % F0fundamental frequencynhrnoise-to-harmonic ratiomptmean phonation time, MFRmean flow ratep subsubglottic pressure, Vevocal efficiencycqclosedquotient p-values from signed rank test comparing Preop and Postop 874 Korean J Otolaryngol 2000;43:873-7
3 Fig. 3. Changes of pre- and post-operative voice parameters numbers in gray box means mean value of each parameters, n
4 876 Korean J Otolaryngol 2000;43:873-7
5 REFERENCES 1) Turck L. Chronic inflammatory disease of the vocal cord. Wien: Wilheim Brauller; ) Reinke F. Untersuchungen uber das menschliche Stimmband. Fortschr Med 1895;13: ) Tillmann B, Rudert H, Schunke M, Werner JA. Morphological studies on the pathogenesis of reinke s edema. Eur Arch Otolaryngol 1995;252: ) Kleinssaser O. Pathogenesis of vocal cord polyp. Ann Otol Rhinol Laryngol 1981;91: ) Song DW, Park HT, Kim DC, Kim JG, Chang ES. Clinical and histopathological analysis of laryngeal polyp and vocal nodule. Korean J Otolaryngol 1990;33: ) Wallner L. Smoker's larynx. Laryngoscope 1954;64: ) Zeitels SM, Hillman RE, Bunting GW, Vaughn T. Reinke s edema: phonatory mechanisms and management strategies. Ann Otol Rhinol Laryngol 1997;106: ) Koufman JA. Gastroesophageal reflux and voice disorders. In: Rubin JS, Sataloff RS, Korovin GS, Gould WJ, eds. Diagnosis and treatment of voice disorders. New York. NY: Igaku-Shoin ;1995. p ) Hocevar-Boltezar I, Radsel Z, Zargi M. The role of allergy in the etiopathogenesis of laryngeal mucosal lesions. Acta Otolaryngol 1997;527: ) Yonekawa H. A clinical study of reinke s edema. Auris Nasus Larynx 1988;15: ) Choi HS, Ko JW, Kim KM, Kim KH, Kim MS, Kim YM, et al. Efficacy profiles of cisapride in laryngopharyngeal reflux LPRrelated symptoms open multicenter case study open multicenter case study between cisapride ranitidine. J Korean Logo Phon 1998;9: ) Kim KM, Kim GR, IM HS, Chang G. Clinical evaluation of Reinke s edema. J Korean Logo Phon 1995;6: ) Kim SG, Choi HS, Kong SC, Hong WP. Acoustic analysis of Reinke s endema. J Korean Logo Phon 1996;7:
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KISEP Head and Neck Korean J Otolaryngol 2000;43:1232-6 라인케부종의 Videostrobokymography 소견 김광현 성명훈 김동영 이동욱 이상준 이승신 박민현 김정준 Videostrobokymographic Analysis of Reinke s Edema Kwang Hyun Kim, MD, Myung-Whun
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