Exudative laryngeal diseases of Reinke's space: a clinicohistopathological framing

J Otolaryngol. 2002 Dec;31(6):376-80. doi: 10.2310/7070.2002.34517.

Abstract

Objective: To establish the relationship between the macroscopic and histologic diagnosis of nodules, polyps, and Reinke's edema of the true vocal folds and to propose a clearer clinical definition of them in the hope of settling the difference of opinion between otolaryngologists and pathologists.

Design: Retrospective study

Setting: Otolaryngology Department of "La Sapienza" University of Rome.

Methods: The pathologic reports of 203 patients subjected to direct laryngoscopy were studied.

Main outcome measures: Examination of the histologic specimen of the epithelium and the chorion.

Results: Microscopic examination revealed a high percentage of normal epithelium both for nodules (33.79%) and polyps (40.65%). No dysplasia was observed, whereas dysplasia was present in 10 cases of Reinke's edema (7 laryngeal intraepithelial neoplasia 1 and 3 laryngeal intraepithelial neoplasia II). Five different stages of histologic progression resulted from the examination of the chorion in both nodules and polyps.

Conclusions: Our suggestion is to consider polyps as "older" lesions and nodules as "younger" lesions. A polyp may be defined as an abnormal unilateral growth of vocal folds, a nodule as a bilateral growth situated between the anterior and medium third of the vocal fold, and Reinke's edema as a bilateral wound that extends to the whole of the true vocal fold.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chorion / pathology
  • Chorion / ultrastructure
  • Diagnosis, Differential
  • Exudates and Transudates / cytology*
  • Female
  • Hemangioma / classification
  • Hemangioma / diagnosis*
  • Hemangioma / pathology*
  • Humans
  • Hyalin / cytology*
  • Hyalin / ultrastructure*
  • Laryngeal Diseases / classification
  • Laryngeal Diseases / diagnosis*
  • Laryngeal Diseases / pathology*
  • Laryngeal Edema / classification
  • Laryngeal Edema / diagnosis*
  • Laryngeal Edema / pathology*
  • Laryngeal Mucosa / pathology
  • Laryngeal Mucosa / ultrastructure
  • Laryngeal Neoplasms / classification
  • Laryngeal Neoplasms / diagnosis*
  • Laryngeal Neoplasms / pathology*
  • Laryngoscopy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Vocal Cords / pathology*
  • Vocal Cords / ultrastructure*