Voice analysis of patients with diverse types of Reinke's edema and clinical use of electroglottographic measurements.
CONCLUSIONS
Reinke's edema shows a variety of clinical patterns and differences in voice analysis depending on its type. Electroglottographic measurements help to objectively assess the severity of edema and voice quality before and after surgery.


OBJECTIVE
Reinke's edema manifests various clinical findings and different voice characteristics depending on the degree of swelling and the severity of voice impairment. The aim of this study was to compare the aerodynamic, acoustic and electroglottographic parameters for the different types of Reinke's edema according to its morphological, perceptual and histopathological classifications, and to assess voice quality in patients with Reinke's edema before and after laryngomicrosurgery. We also aimed to determine which parameter was most associated with the improvement in postoperative voice quality and to investigate the clinical usefulness of electroglottographic analysis in Reinke's edema.


METHODS
The clinical and voice records of 61 patients with Reinke's edema were reviewed. All the patients were classified according to stroboscopic findings (Yonekawa's classification), perceptual grade and histopathological findings. Voice analysis of the perceptual, acoustic, aerodynamic and electroglottographic measurements was carried out using various classifications, and the voices of 23 patients who underwent laryngomicrosurgery were evaluated 2 months after surgery. Furthermore, the voices of 30 normal speakers (controls) were recorded and analyzed.


RESULTS
The fundamental frequency (FxM) of Yonekawa Type III was significantly lower than those of the other types of Reinke's edema, and the SD of the FxM, the percentage irregularity of the FxM (CFx) and the percentage irregularity of the amplitude were larger than those of the other types of Reinke's edema. The closed quotient was significantly higher in Yonekawa Type III. In addition, the mean flow rate (MFR), maximum phonation time and harmonics:noise ratio (HNR) differed significantly among the different types of Reinke's edema. The postoperative results showed an increase in the FxM and an improvement in the MFR, subglottic pressure, shimmer and HNR. Correlation analysis showed that jitter, the HNR, the mean closed quotient and the irregularity of the frequency were the parameters that had the best correlation with improvement in postoperative voice quality.
Lim
Jae-Yol
JY
Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Choi
Jae-Nam
JN
Kim
Kwang-Moon
KM
Choi
Hong-Shik
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007819:Laryngeal Edema / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D007828:Laryngoscopy; D007830:Larynx / Q000601:surgery; D008297:Male; D008875:Middle Aged; D049489:Stroboscopy; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology; D014833:Voice Quality