Vocal Fold Vibration of Patients with Reinke's Edema Observed Using High‐Speed Digital Imaging

Abstract

Objectives: 1) Assess vocal fold vibration of patients with Reinke’s edema using high-speed digital imaging (HSDI) and videostoroboscopy. 2) Confirm that HSDI is useful for examining vocal folds with severe Reinke’s edema. Methods: Study design is observational and cross-sectional. The subjects were 7 patients with Reinke’s edema (6 severe, 1 moderate; 6 female, 1 male; 55–74 years of age, mean 64.7 years). Their vocal folds were examined with HSDI system (1200 fps) and videostoroboscopy before microphonosurgery from October 2009 through February 2012. The following characteristics of vocal fold vibration were analyzed; glottic closure, mucosal wave propagation, symmetry, phase shift, frequency difference, periodicity, and contact with false vocal fold. Postoperative examinations were also performed in 5 subjects. Results: HSDI revealed periodic or quasi-periodic vibration, anterior-posterior phase shift, and contact of true and false vocal folds in all patients before surgery. Distinct left-right asymmetry of vibration was observed in 6 patients. The vocal fold vibrations could not be tracked in 4 with severe edema. After surgery the vibrations became periodic and synchronized with strobolights in all patients. Little left-right asymmetry of vibration remained in all patients. Conclusions: Though the vocal fold vibrations with Reinke’s edema were periodic or quasi-periodic, they were often difficult to observe with videostroboscopy in severe cases. HSDI can be a very useful tool for examining the vocal folds of patients with severe Reinke’s edema, especially before surgery to find scarring and tumor.