Chronic edematous-polypous laryngitis (Reinke – Gayek disease) as a cause of hoarseness. Personalized approach to the surgical treatment

Abstract

Introduction. Chronic edematous-polypous laryngitis, Reinke – Gayek’s edema accounts for 5.5% of all benign diseases of the vocal folds. Surgical treatment of Reinke – Gayek disease consists in removing excess mucosa, or “stripping” – tearing off a strip of mucosa with forceps from the vocal fold. The principle of laryngeal surgery is to preserve the structures of the vocal fold, to obtain flexible vibration of the muscular-membranous part and the mucous membrane of the vocal fold.Purpose. Improving the effectiveness of the treatment of patients with Reinke – Hayek edema by developing sparing methods of surgical treatment using a carbon dioxide laser. To develop criteria for choosing a method of sparing surgical treatment of Reinke – Hayek edema using a carbon dioxide laser, depending on the type of edema according to the Yonekawa classification.Materials and methods. 80 patients with Reinke – Gayek’s disease, 59 women and 21 men, from 29 to 77 years old, divided into two subgroups, and a control group were treated. Preoperative examination included endoscopic examination, laryngostroboscopy. The type was determined according to the H. Yonekawa classification. In type II, subgroup 1 – aspiration technique, n = 30. In type III, subgroup 2 – M-shaped technique, n = 30. Control group, it includes patients with type II and III edema, resection technique, n = 20.Results. Patients in the preoperative period were surveyed with the SF-36 Health Status Survey questionnaire, the dysphonia severity index (DSI), as well as the time of maximum phonation. In the postoperative period, they were examined, 1 month after the operation and 6 months after the operation. There is an increase in indicators, an increase in the time of maximum phonation, an increase in SF-36 scores.Conclusion. The use of this technique made it possible to significantly accelerate the recovery of the voice, reduce the time spent in the hospital, minimally damaging the structure of the mucous membrane of the vocal folds.