Long-term cigarette smoke exposure has been described as an etiological factor in a myriad of aberrant conditions of the vocal folds, including carcinoma, and a range of benign responses, including Reinke edema (RE). Clinically, RE is described as unilateral or bilateral swelling of the entire vocal fold with hypermobility during phonation.1 Although historically RE was thought to be a precancerous lesion, current thinking holds that RE is a benign process characterized by altered number and size of microvessels within the subepithelial space and compromised intercellular junctions, especially in basal and spinous layers.2 Within the lamina propria, the generally organized collagen architecture is disrupted.3 Cumulatively, these alterations to the delicate, layered structure of the vocal folds often lead to the characteristic rough, low-pitched voice found in RE. In severe cases, airway obstruction due to marked RE has been reported.
Sugumaran M, Sulica L, Branski RC. Reinke Edema Finding on Positron Emission Tomography. Arch Otolaryngol Head Neck Surg. 2011;137(6):620-621. doi:10.1001/archoto.2011.35