Voice Quality Analysis of Reinke's Edema According to Recent New Classification



      Reinke's edema is a benign laryngeal disease characterized by inflammation and swelling of the superficial layer of the lamina propria of the vocal fold, known as Reinke's space. The aim of this study was to evaluate the quality of voice by quantitative acoustic measurements in patients affected by RE according to new classification proposed by de Vincentiis.

      Study Design

      Prospective case-control.


      We enrolled 76 consecutive patients with RE: eight type 1, 36 type 2, four type 3. and 28 type 4. A population of 30 healthy subjects was enrolled too. A voice recording for each subject was performed and the analysis were performed using the Multi-Dimensional Voice Program. The parameters considered were: fundamental frequency (F0), Jitter% (Jitt%), Shimmer% (Shim%), and Noise Harmonics to Ratio (NHR). Statistical analyses were performed using GraphPad Prism 8 software. A level of significance of P < 0.05 was used.


      The mean values and standard deviation for each parameter for the male group of patients affected by RE are: F0 101.06 (± 9.56) Hz, Jitt% 2.254 (±0.93), Shim% 9,037 (±2.21) and NHR 0.235 (±0.099). About the female group, the mean values are: F0 147,58 (±13.68) Hz, Jitt% 3,733 (±1.12), Shim% 11.172 (±3.54) and NHR 0.278 (±0.12). The difference between the types of RE and reference sample people in male and female groups are statistically significative (P < 0.05) for each parameter. In the female group all outcomes are statistically different except the F0 and NHR between healthy people and type III RE patients.


      RE is one of the most common diseases of true vocal folds and the classification proposed by de Vincentiis is a synthesis of endoscopic findings. In this paper we underline the change in vocal quality before surgery according a new type of RE classification.

      Key Words

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        • Tavaluc R
        • Tan-Geller M
        Reinke's Edema.
        Otolaryngol Clin North Am. 2019; 52: 627-635
        • Tan M
        • Bryson PC
        • Pitts C
        • et al.
        Clinical grading of Reinke's edema.
        Laryngoscope. 2017; 127: 2310-2313
        • Lechien JR
        • Saussez S
        • Nacci A
        • et al.
        Association between laryngopharyngeal reflux and benign vocal folds lesions: a systematic review.
        Laryngoscope. 2019; 129: E329-E341
        • Lim JY
        • Choi JN
        • Kim KM
        • et al.
        Voice analysis of patients with diverse types of Reinke's edema and clinical use of electroglottographic measurements.
        Acta Otolaryngol. 2006; 126: 62-69
        • Yonekawa H
        A clinical study of Reinke's edema.
        Auris Nasus Larynx. 1988; 15: 57-78
        • Kraft M
        • Glanz H
        • Gerlach Sv
        • et al.
        Morphologische Klassifikation des Reinke-Odems mittels optischer Kohärenztomografie [Morphologic classification of Reinke's edema through optical coherence tomography].
        Laryngorhinootologie. 2010; 89: 224-227
        • de Vincentiis M
        • Ralli M
        • Cialente F
        • et al.
        Reinke's edema: a proposal for a classification based on morphological characteristics.
        Eur Arch Otorhinolaryngol. 2020; 277: 2279-2283
        • Li G
        • Hou Q
        • Zhang C
        • et al.
        Acoustic parameters for the evaluation of voice quality in patients with voice disorders.
        Ann Palliat Med. 2021; 10: 130-136
        • Martins RH
        • Fabro AT
        • Domingues MA
        • et al.
        Is Reinke's edema a precancerous lesion? Histological and electron microscopic aspects.
        J Voice. 2009; 23: 721-725
        • Moesgaard Nielsen V
        • Højslet PE
        • Palvio D
        Reinke's oedema: a premalignant condition?.
        J Laryngol Otol. 1986; 100: 1159-1162
        • Plch J
        • Pár I
        • Navrátilová I
        • et al.
        Long-term follow-up study of laryngeal precancer.
        Auris Nasus Larynx. 1998; 25: 407-412
        • Tavaluc R
        • Herman H
        • Lin J
        • et al.
        Does Reinke's edema grade determine premalignant potential?.
        Ann Otol Rhinol Laryngol. 2018; 127: 812-816
        • Zhukhovitskaya A
        • Battaglia D
        • Khosla SM
        • et al.
        Gender and age in benign vocal fold lesions.
        Laryngoscope. 2015; 125: 191-196
        • Goswami S
        • Patra TK
        A clinico-pathological study of Reinke'S oedema.
        Indian J Otolaryngol Head Neck Surg. 2003; 55: 160-165
        • Zeitels SM
        • Casiano RR
        • Gardner GM
        • et al.
        Management of common voice problems: Committee report.
        Otolaryngol Head Neck Surg. 2002; 126: 333-348
        • Izadi F
        • Mohseni R
        • Daneshi A
        • et al.
        Determination of fundamental frequency and voice intensity in Iranian men and women aged between 18 and 45 years.
        J Voice. 2012; 26: 336-340
        • Verdonck-de Leeuw IM
        • Festen JM
        • Mahieu HF
        Deviant vocal fold vibration as observed during videokymography: the effect on voice quality.
        J Voice. 2001; 15: 313-322
        • Krival K
        • Kelchner LN
        • Weinrich B
        • et al.
        Vibratory source, vocal quality and fundamental frequency following pediatric laryngotracheal reconstruction.
        Int J Pediatr Otorhinolaryngol. 2007; 71: 1261-1269
        • Watanabe T
        • Kaneko K
        • Sakaguchi K
        • et al.
        Vocal-fold vibration of patients with Reinke's edema observed using high-speed digital imaging.
        Auris Nasus Larynx. 2016; 43: 654-657