Voice disorders can result from the swelling of the non-muscle part of the vocal fold that is right underneath its surface lining (i.e., in the superficial lamina propria, also known as Reinke's space). This condition is called Reinke's edema, which literally means "swelling in Reinke's space" or "build-up of fluid in Reinke's space."
A change in a vocal fold causes change in vocal fold vibration. The vocal fold swelling makes the superficial lamina propria (Reinke's space) stiff, thus reducing vocal fold vibration – hence voice changes and/or problems. (For more information, see Anatomy & Physiology of Voice Production.)
Patients usually have a low, raspy, or rough voice. A low voice is particularly striking in women – a male-quality voice in a female.
Reinke's edema is caused by vocal fold irritation from voice misuse, smoking, and/or conditions that irritate the vocal folds, such as backflow of stomach fluids to the voice box (laryngopharyngeal reflux). Reinke's edema typically occurs in middle-aged/post-menopausal women who have a long-term history of smoking cigarettes.
Reinke's edema does not go away on its own.
The cause of Reinke's edema needs to be identified and treated before treatments directed at the voice disorder (such as voice therapy or surgery) are considered.
Elements of Successful Treatment
Long-term success in the treatment of Reinke's edema requires two, sometimes three approaches.
Fixing the underlying cause (e.g., stop smoking, treat reflux, eliminate voice overuse or abuse)
Although Reinke's edema usually develops slowly over the course of many years, the condition can worsen to the point of causing problems with breathing (airway problems).
What is Reinke's edema?
Swelling from Fluid Accumulation in Reinke's Space
Reinke's edema is the build-up of a gelatinous substance in the layer right underneath the surface lining of the vocal folds (superficial lamina propria or Reinke's space. It may occur in one or both vocal folds.
Reinke's Space Is Not an "Empty Space"
The superficial lamina propria, or Reinke's space, is not an empty space. It has a defined structure made up of cells, special fibers, and substances made by cells. (For more information, see Anatomy & Physiology of Voice Production.)
The superficial lamina propria (Reinke's space) plays an important role in the vibration of vocal folds, which is a key element in sound production.