[Phonatory characteristics following different endolaryngeal microsurgical techniques in Reinke's disease]

The aim of the study was to compare different surgical techniques in treatment of Reinke's edema according to subjective and quantitative changes of voice characteristics. We evaluated 62 surgically treated patients from 34 to 68 years (mean 47.7 years) with Reinke's edema. Two endolaryngeal microsurgical methods were used: classical as mechanical stripping of the mucosa-Ist, mechanical stripping group (n = 30), and removal of fluid through aspiration with preservation of vocal cord medial edges mucosa-IInd, preserving mucosa group (n = 32). Clinical voice assessment was composed of laryngoscopy, subjective voice evaluation (GRBAS hoarseness scale, visual analogue scale of voice quality, and pitch) and quantitative voice evaluation (seven quantitative voice parameters obtained from voice range profile (VRP) and registering of maximum phonation time). Patients were evaluated twice--before operation and at mean 23.8 days after. Postoperative follow-up data was registered from 57 patients: 28 from Ist and 29 from IInd groups. According to our data the positive dynamics for all voice parameters was observed in both patients' groups. Surgical approach with preservation of vocal cord medial edges mucosa on overall benefit after operation according to the voice quality is statistically significantly better compared to classical operation technique (chi 2 = 8.9, p = 0.029). While comparing these two approaches statistically significant differences were found for subjective voice parameters--grades of hoarseness and roughness, and for quantitative VRP parameters: pitch range, maximum-minimum intensity range, total voice area, and overall vocal dysfunction degree. The mean values of most voice parameters in early postsurgery period significantly differed from normal. Clinical voice assessment may be useful for evaluation of surgical treatment efficacy as well as for comparison of surgical techniques.