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 1998. 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
Fig. 1. Laryngoscopic findings according to Yonekawa 1998. 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 116.76 132.48 0.1881 159.39 172.30 0.1152 Jitter % 2.84 1.35 0.0487* 2.24 2.27 0.8154 Shimmer % 7.21 3.3 0.004* 5.38 2.88 0.001* NHR 0.19 0.16 0.3821 0.14 0.15 0.4209 MPT sec 7.72 10.97 0.0001* 6.67 8.86 0.0488* MFR ml/sec 259.37 167.91 0.0403* 340.36 239.81 0.0485* Psub cm/h2o 14.43 10.26 0.0001* 10.79 11.2 0.6846 Ve ppm 37.23 43.92 0.0466* 121.75 44.72 0.6855 CQ % 49.31 51.14 0.3494 50.05 49.06 0.7490 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
Fig. 3. Changes of pre- and post-operative voice parameters numbers in gray box means mean value of each parameters, n25. 875
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