CLINICAL AND MORPHOLOGICAL PARALLELS IN DIFFERENT VARIANTS OF EXUDATIVE LESIONS OF REINKE’S SPACE

Abstract

Introduction. The prevalence of exudative lesions of Reinke’s space (EPPR) is high and is of particular medical and social significance. Despite the similarity of clinical manifestations and a certain commonality of pathogenesis, there are morphological differences between various forms of EPPR. Purpose. to study the clinical and morphological features of various forms of EPPR. Materials and methods. The sampling of material for the study was carried out intraoperatively in 56 patients aged 28–56 years with a diagnosis of J38.1 Polyp of the vocal fold and larynx. Conducted indirect laryngoscopy and questioning. Tumor excision was performed using an Olympus TYPE 150 fiber bronchoscope (Germany). The material was fixed in 10% formalin and embedded in paraffin. Prepared standard sections, stained with hematoxylin-eosin. For microscopy, a DMRXA microscope (Leika, Germany) was used. Results. All patients presented the same type of complaints of dysphonia, sensation of a foreign body in the throat, cough, regardless of gender and professional affiliation. According to the results of a morphological study, 22 patients were diagnosed with vocal fold polyps, 18 patients with vocal nodules, and 16 patients with Reinke’s edema. Reinke’s edema and myxoid type of polyps had similar morphological features: pronounced edema of the stroma and small cystic infiltration with cavities filled with gelatinous fluid, the predominance of lymphocytes and histiocytes in the tissues. Vocal nodules and polyps of the angiomatous type were characterized by a high specific density of the vascular component, more pronounced circulatory disorders, and tissue infiltration with fibroblasts. Discussion. Despite the similar clinical manifestations and the commonality of the mechanisms of the formation of EPPR, which consist in increased permeability and fragility of the capillary bed against the background of chronic intoxication and phonotrauma, combined with difficulty in outflow of lymph due to the anatomical features of the lymphatic drainage system of the larynx region, there are morphological features that allow you to clearly differentiate various forms EPPR. Conclusions: the identified morphological features of various forms of EPPR allow us to combine Reinke’s edema and myxoid polyps into one clinical and morphological subgroup, and vocal nodules and angiomatous type of polyps into another.