Voice outcomes in high-grade Reinke's edema: Comparing microflap excision and microdebrider surgery

Area of Science:

• Otolaryngology
• Laryngology
• Surgical Innovation

Background:

• High-grade Reinke's edema (RE) often necessitates surgical intervention due to polypoid changes in the true vocal folds.
• Conservative management frequently fails, leading to surgical consideration for RE.
• Vocal fold surgery aims to restore voice quality and function.

Purpose of the Study:

• To compare patient outcomes following microflap excision versus microdebrider excision for high-grade Reinke's edema.
• To evaluate the efficacy of two surgical techniques in improving voice-related quality of life and phonation time.

Main Methods:

• A cohort of 115 patients with grade II or III RE underwent either microflap or microdebrider surgery.
• Voice outcomes were assessed using the Voice Handicap Index (VHI-30), Voice-Related Quality of Life (V-RQOL), and maximum phonation time (MPT).
• Measurements were taken preoperatively and at 1-month and 6-months postoperatively.

Main Results:

• Both microflap and microdebrider excision led to significant improvements in VHI-30, V-RQOL, and MPT at 1 and 6 months.
• The microdebrider group demonstrated statistically better VHI-30 (40.84 vs 44.54) and V-RQOL (62.56 vs 57.79) scores at 6 months.
• No significant differences were noted at the 1-month follow-up.

Conclusions:

• Both microflap and microdebrider excision are effective surgical treatments for high-grade Reinke's edema.
• Microdebrider excision shows superior voice-related outcomes at the 6-month mark compared to microflap excision.
• These findings support the use of both modalities, with a potential advantage for microdebrider in long-term voice quality.