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Highlights  |  Understanding the Disorder  |  Symptoms  |  Diagnosis  |  Treatment

Understanding Reinke's Edema

Key Glossary TermsKey Glossary Terms

Reinke's Edema
"Swelling in Reinke's space"; a voice disorder caused by accumulation of gelatinous substance in Reinke's space

Reinke's Space (Superficial Lamina Propria)
Layer just underneath the surface lining of the vocal fold; composed of cells, special fibers, and other substances (extracellular matrix); has key role in vocal fold vibration

"Stripping"
A "radical" surgical procedure that removes ("strips") the top layers of the vocal folds resulting in severe vocal fold scarring and abnormal voice. Due to the resultant damage, this procedure is at present rarely used


What is Reinke's edema?
Swelling from Fluid Accumulation in Reinke's Space

Reinke's edema is the build-up of a gelatinous substance in the layer right underneath the surface lining of the vocal folds (superficial lamina propria or Reinke's space). It may occur in one or both vocal folds.

Reinke's Space Is Not an "Empty Space"

The superficial lamina propria, or Reinke's space, is not an empty space. It has a defined structure made up of cells, special fibers, and substances made by cells. (For more information, see Anatomy & Physiology of Voice Production.)

The superficial lamina propria (Reinke's space) plays an important role in the vibration of vocal folds, which is a key element in sound production.

A View of Reinke's Edema
Vocal Folds with Reinke's Edema – Closed Normal Vocal Folds – 95% Closed
Affected vocal cords Normal vocal folds

Vocal folds (vf) with Reinke's Edema in closed position show increased size and volume; arrow indicates midline.
Note: Vocal fold length matched in magnification to normal vocal folds

Normal vocal folds (vf) in almost fully closed position show normal size and volume.

Legend: Viewed from above with person facing examiner, vf, vocal folds; R, patient's right; L, left, back and front of voice box.

(click photos for larger images)

How does Reinke's Edema affect voice?

Vocal fold vibration is critical for production of sound during speaking or singing. Reinke's space, or superficial lamina propria, plays a key role in vocal fold vibration. Along with the lining cover, Reinke's space undergoes a wave-like motion, or "mucosal wave," during speaking or singing. Any change in shape, volume, flexibility, composition, and/or consistency of this layer results in voice changes.

Voice changes are usually described as: hoarse, raspy, low voice quality, as well as decrease in loudness (volume), and difficulties in how high/low a voice can reach (voice range).

Key InformationKey Information
  • Reinke's edema is sometimes incorrectly indentified as:
    • Laryngeal polyp
    • Polypoid corditis
    • Vocal fold edema
    • Smoker's laryngitis
    • Chronic laryngitis
  • The conditions listed above are distinct and can sometimes present at the same time as Reinke's Edema.
  • Careful examination is necessary to arrive at the correct medical diagnosis.
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