"Cold-Steel" Phonosurgery of Reinke Edema Evaluated by the Multidimensional Voice Program

Area of Science:

• Otolaryngology
• Speech and Language Pathology

Background:

• Reinke edema presents challenges for phonosurgery due to delicate vocal fold structures.
• Preserving vocal fold integrity during surgery is crucial for voice outcomes.

Purpose of the Study:

• To evaluate the efficacy of "cold-steel" phonosurgery (PS) for Reinke edema.
• To assess voice quality changes using the Multidimensional Voice Program (MDVP) post-surgery.

Main Methods:

• Seventy-six patients with Reinke edema underwent phonosurgery between 2003 and 2007.
• Voice analysis included MDVP (measuring jitter, shimmer, soft phonation index, fundamental frequency - f0), videostroboscopy, and a voice outcome score.
• Pre- and postoperative data were analyzed for 14 female patients.

Main Results:

• Significant improvements observed in fundamental frequency (f0) and decreased jitter 3 months post-PS.
• Videostroboscopy findings correlated with jitter, indicating vocal fold status.
• Patients with higher preoperative vocal deviations showed greater improvement; edema reduction was consistent.
• Most patients (95%) were smokers preoperatively, with limited changes in habits.

Conclusions:

• MDVP parameters (f0, jitter) effectively reflect voice improvement and edema reduction post-phono surgery.
• Suboptimal outcomes can result from extensive tissue removal, chronic vocal abuse, and persistent smoking.
• Phonosurgery is effective, but patient factors significantly influence long-term results.