Department of Otorhinolaryngology, University of Catania, Via S.Sofia 14, 95125, Catania, Italy.
Eur Arch Otorhinolaryngol. 2022 Aug;279(8):4053-4059. doi: 10.1007/s00405-022-07377-9. Epub 2022 Apr 11.
To present our experience with a new microsurgical approach for treatment of the Reinke's edema in suspension laryngoscopy-microdebridement. After a short review of existing literature we introduce speech therapy before and after the surgery into the protocol.
The authors compare the phonatory outcome, laryngostroboscopical results and subjective improvement of the voice of 30 patients with Reinke's edema that were operated with either microdebridement or cold steel surgery techniques. "Sandwich" speech therapy strategy was applied for the vocal rehabilitation before and after surgery in both patient groups.
After the microdebridement and the speech therapy the mucosal wave was regular, symmetric and periodic in all patients. No signs of abnormal scar tissue or anterior adhesions were observed. Significant improvement of vocal parameters was found after the surgery in both groups of patients: operated with the microdebridement technique and the cold steel technique. The subjective voice evaluated by Voice Handicap Index (VHI-10) was improved for both patient groups in a homogenous way.
Based on the similarity of the vocal outcome in the two groups, microdebridement of the vocal folds is an excellent method for removing the edema of the Reinke's space. Careful suction at a low voltage protects the lamina propria during the microdebridement. The authors discuss the indication to this innovating procedure in patients with difficult laryngeal exposure and small operating field.
介绍我们在悬雍垂喉镜-显微清创术治疗 Reinke 水肿方面的新微创手术经验。在简要回顾现有文献后，我们将术前和术后语音治疗纳入了方案。
作者比较了 30 例接受显微清创术或冷钢手术治疗的 Reinke 水肿患者的发声效果、喉频闪检查结果和声音主观改善情况。在两组患者中，均采用“三明治”式语音治疗策略进行术前和术后的嗓音康复。
在显微清创术和语音治疗后，所有患者的黏膜波均规则、对称且周期性。未观察到异常瘢痕组织或前粘连的迹象。两组患者手术后的嗓音参数均有显著改善：接受显微清创术和冷钢技术治疗的患者。通过嗓音障碍指数（VHI-10）评估的主观嗓音也以相同的方式得到改善。
基于两组患者的发声效果相似，声带的显微清创术是去除 Reinke 间隙水肿的极佳方法。在显微清创过程中，以低电压小心抽吸可保护固有层。作者讨论了在喉暴露困难和手术视野小的患者中应用这一创新手术的适应证。
