Exudative lesions of Reinke’s space: a terminology proposal

Hantzakos, Anastasios G; Remacle, Marc; Dikkers, Frederik G.; Degols, J.; Delos, Monique; Friedrich, Gerhard; Giovanni, Antoine; Rasmussen, Niels

doi:10.1007/s00405-008-0863-x

Cited by 71 publications

(44 citation statements)

References 21 publications

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“…Therefore, they recommended use of a unifying histopathologic term for clinically defined polyps, nodules, and Reinke's edema. 11 The findings in the present study support this recommendation. Of 46 cases classified by 2 ENTs, they agreed in 43% (mostly polyps and nodules) and disagreed in 57% of cases.…”

Section: Discussionsupporting

confidence: 91%

The Clinicopathologic Spectrum of Benign Mass Lesions of the Vocal Fold due to Vocal Abuse

et al. 2011

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Benign masses of the vocal fold related to phonotrauma are clinically classified into polyps, nodules, Reinke's edema, and cysts. Despite the apparent distinctiveness of the clinical nomenclature, low inter- and intraobserver diagnostic agreement has been reported. Excepting cysts, which are epithelial lined, histologic examination of the remaining lesions has shown a variety of overlapping features insufficiently specific for the clinical diagnoses. This study reviews the clinicopathologic characteristics among these benign lesions of the vocal fold. A total of 78 nonneoplastic lesions of the vocal fold were reviewed by 2 pathologists for the presence of epithelial hyperplasia, basement membrane thickening, edema, vascular proliferation, and extracellular "amyloid-like" fibrin. In 46 cases with prebiopsy stroboscopic images, 2 otolaryngologists classified each lesion as polyp, nodule, Reinke's edema, cyst, or other. They agreed in 43% (n = 20, 13 polyps, 5 nodules, 1 Reinke's edema, 1 other) and disagreed in 57% (n = 26). There was no histologic feature that reliably distinguished among the lesions. In addition, reactive stromal cell atypia was present in 14 cases. Cysts were distinctive, as all were epithelial lined. The clinicopathologic classification of benign laryngeal lesions is neither clinically reproducible nor histologically unique. Treatment will continue to be individualized based on clinical judgment.

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Section: Discussionsupporting

confidence: 91%

The Clinicopathologic Spectrum of Benign Mass Lesions of the Vocal Fold due to Vocal Abuse

et al. 2011

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“…Tais lesões não apresentam alterações histológicas nas camadas intermediária e profunda da lâmina própria da mucosa, nem no corpo da prega vocal, apenas no espaço de Reinke 1,3,28 .…”

Section: Afecções Laríngeas Organofuncionais Do Tipo Nódulos Póliposunclassified

Lesões organofuncionais do tipo nódulos, pólipos e edema de Reinke

et al. 2011

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TEMA: lesões organofuncionais são formações benignas decorrentes de comportamento vocal alterado e inadequado, sendo as mais comuns: nódulos, pólipos vocais e edema de Reinke. OBJETIVO: realizar um estudo comparativo dos dados descritos na literatura sobre prega vocal normal e afecções organofuncionais do tipo nódulos, pólipos e edema de Reinke. O estudo foi realizado por meio de um levantamento bibliográfico em periódicos indexados no Science Direct, periódicos Capes, LILACS, SciELO, MedLine e Scopus e livros, no período de 1999 a 2010. CONCLUSÃO: a distribuição dos constituintes da matriz extracelular da lâmina própria lw32da mucosa, fibras elásticas, colágenas, ácido hialurônico e fibronectina, encontra-se alterada nas três afecções. Ocorre modificação das características vibratórias de amplitude, propagação da onda de mucosa e simetria do padrão vibratório devido à presença do aumento de massa nas pregas vocais, ao contrário do que se observa nas pregas vocais sem afecção. O sinal perceptivo-auditivo da qualidade vocal encontrado nas três lesões é a rouquidão, seguida da soprosidade e da aspereza (exceção do edema de Reinke), sinalizando a presença de ruído acústico à emissão, estando presente também, no edema de Reinke, o agravamento considerável da frequência fundamental. Quanto à etiologia observou-se a predominância dos usos incorretos, e quanto à incidência, nódulos e edema de Reinke predominam no sexo feminino e pólipos no sexo masculino.

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“…Additionally, this study sought to find diagnostic concordance for conditions such as benign vocal fold lesions in which there is much disagreement regarding the basic diagnostic criteria. 14,15 For instance, it is unclear whether the diagnostic variability in the present study with vocal fold nodules represents limitations of the imaging modality or the agreement as to the physical appearance of those nodules. Finally, the wide range of diagnostic possibilities engaged multiple levels of variability, which ultimately limits the statistical power of the findings.…”

Section: Discussionmentioning

confidence: 83%

The Diagnostic Role of High-Speed Vocal Fold Vibratory Imaging

Mendelsohn

Remacle²,

Courey

et al. 2013

Journal of Voice

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Summary: Objective. Although high-speed imaging (HSI) has been identified as a valuable tool in phonatory biomechanics research, to date, there have only been a selected number of reports investigating the clinical utility of HSI. We aim to elucidate the role of HSI in the diagnosis of the dysphonic patient. Methods. The video files from 28 consecutive dysphonic patients with concurrently acquired videostroboscopy and HSI were retrospectively collected. Stroboscopy video files were edited to include vibratory motion only. Videos were then anonymously and randomly presented to four academic laryngologists. Experts were asked to assign a single best diagnosis for each video file. Assigned diagnoses were then compared with treatment diagnoses conferred based on medical history, phonatory evaluation, laryngeal examination, and response to treatment. Results. Interrater analysis for the four laryngologists demonstrated significant and meaningful correlations for the diagnoses of polyps, cysts, nodules, and normal examination using stroboscopy (kappa > 0.40, P < 0.001). The experts demonstrated significant and meaningful correlations for the diagnoses of polyps, presbyphonia, and normal examination using HSI (kappa > 0.40, P < 0.001). Combined intrarater analysis performed by comparing single rater's diagnosis for single patient across both modalities resulted in poor correlation without statistical significance (kappa ¼ 0.30, P ¼ 0.07). Both stroboscopy-and HSI-assigned diagnoses matched the treatment diagnoses at equal predicted frequencies (32.3%), as demonstrated through multivariate logistic regression analysis (P < 0.001). Conclusion. Overall, HSI did not improve the diagnostic accuracy above stroboscopy alone. Although specific laryngeal states such as presbyphonia may be better diagnosed with HSI, further studies are required to define HSI's precise role in the clinical setting.

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Exudative lesions of Reinke’s space: a terminology proposal

Cited by 71 publications

References 21 publications

The Clinicopathologic Spectrum of Benign Mass Lesions of the Vocal Fold due to Vocal Abuse

The Clinicopathologic Spectrum of Benign Mass Lesions of the Vocal Fold due to Vocal Abuse

Lesões organofuncionais do tipo nódulos, pólipos e edema de Reinke

The Diagnostic Role of High-Speed Vocal Fold Vibratory Imaging

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