C Sommer1, H-J Schultz-Coulon. 1. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, plastische Operationen, Phoniatrie und Pädaudiologie, Städtische Kliniken Neuss.
Abstract
BACKGROUND: In the case of Reinke's edema, the usual aim of microlaryngoscopic vocal fold stripping is an improvement of voice quality. Long-term results concerning functional voice quality in the literature vary widely. Whether and to what degree surgical intervention leads to the desired postoperative results is therefore still an open question. Therefore we conducted a follow-up study to review our own treatment results. MATERIALS AND METHODS: We questioned 88 patients treated for Reinke's edema, either orally or by means of a written questionnaire, 6 months to 7 years (mean: 3.5 years) after the operation (longitudinal incision, removal of the edema by suction, resection of surplus vocal cord mucosa), asking about postoperative voice quality and subjective impression of how successful the operation had been. In all 63 patients answered the questionnaire; 16 agreed to undergo follow-up laryngostroboscopy. RESULTS: 51 patients (81%) reported a postoperative improvement in voice quality, 8 patients (13%) rated their voice quality as unchanged, and 4 patients (6%) complained of deterioration in their voice quality. Among the patients whose voices were subject to professional strain (n=27) a lower proportion experienced successful results (voice quality improved: 71%; unchanged: 21%; worse: 8%) than among patients without vocal strain (n=36; improved: 86%; unchanged: 11%; worse: 3%). Postoperative elimination or restriction of such etiological factors as smoking and vocal strain also improved the long-term results. Follow-up examination in 16 patients revealed a good correlation between the patients' subjective reports and the stroboscopic and auditory findings. CONCLUSION: Patients should be selected very carefully for surgical treatment of Reinke's edema. The elimination of etiological factors is of highly significant in terms of the prognosis. Before surgery patients should be fully informed of how uncertain the prognosis is.
BACKGROUND: In the case of Reinke's edema, the usual aim of microlaryngoscopic vocal fold stripping is an improvement of voice quality. Long-term results concerning functional voice quality in the literature vary widely. Whether and to what degree surgical intervention leads to the desired postoperative results is therefore still an open question. Therefore we conducted a follow-up study to review our own treatment results. MATERIALS AND METHODS: We questioned 88 patients treated for Reinke's edema, either orally or by means of a written questionnaire, 6 months to 7 years (mean: 3.5 years) after the operation (longitudinal incision, removal of the edema by suction, resection of surplus vocal cord mucosa), asking about postoperative voice quality and subjective impression of how successful the operation had been. In all 63 patients answered the questionnaire; 16 agreed to undergo follow-up laryngostroboscopy. RESULTS: 51 patients (81%) reported a postoperative improvement in voice quality, 8 patients (13%) rated their voice quality as unchanged, and 4 patients (6%) complained of deterioration in their voice quality. Among the patients whose voices were subject to professional strain (n=27) a lower proportion experienced successful results (voice quality improved: 71%; unchanged: 21%; worse: 8%) than among patients without vocal strain (n=36; improved: 86%; unchanged: 11%; worse: 3%). Postoperative elimination or restriction of such etiological factors as smoking and vocal strain also improved the long-term results. Follow-up examination in 16 patients revealed a good correlation between the patients' subjective reports and the stroboscopic and auditory findings. CONCLUSION:Patients should be selected very carefully for surgical treatment of Reinke's edema. The elimination of etiological factors is of highly significant in terms of the prognosis. Before surgery patients should be fully informed of how uncertain the prognosis is.