Are Vocal Alterations Caused by Smoking in Reinke's Edema in Women Entirely Reversible After Microsurgery and Smoking Cessation?

Autor: Martins RHG; Discipline of Otolaryngology, UNESP Universidade Estadual Paulista, Botucatu, São Paulo, Brazil. Electronic address: rmartins@fmb.unesp.br., Tavares ELM; Speech Therapy, Discipline of Otolaryngology, UNESP Universidade Estadual Paulista, Botucatu, São Paulo, Brazil., Pessin ABB; Speech Therapy, Discipline of Otolaryngology, UNESP Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of voice : official journal of the Voice Foundation [J Voice] 2017 May; Vol. 31 (3), pp. 380.e11-380.e14. Date of Electronic Publication: 2016 Jul 21.
DOI: 10.1016/j.jvoice.2016.06.012
Abstrakt: Background: Reinke's edema is a benign lesion of the vocal folds that affects chronic smokers, especially women. The voice becomes hoarse and virilized, and the treatment is microsurgery. However, even after surgery and smoking cessation, many patients remain with a deep and hoarse voice.
Objectives: The aim of the present study was to compare pre- and postoperative acoustic and perceptual-auditory vocal analyses of women with Reinke's edema and of women in the control group, who were non-smokers.
Methods: A total of 20 women with videolaryngoscopy diagnosis of Reinke's edema who underwent laryngeal microsurgery were evaluated pre- and postoperatively (6 months) by videolaryngoscopy, acoustic voice, and perceptual-auditory analyses (General degree of dysphonia, Roughness, Breathiness, Asthenia, Strain, and Instability [GRBASI] scale), and the maximum phonation times were calculated. The pre- and postoperative parameters of the women with Reinke's edema were compared with those of the control group of women with no laryngeal lesions, smoking habit, or vocal symptoms.
Results: Acoustic vocal perceptual-auditory analyses and the maximum phonation time of women with Reinke's edema improved significantly in the postoperative evaluations; nevertheless, 6 months after surgery, their voices became worse than the voices of the women from the control group.
Conclusions: Abnormalities caused by smoking in Reinke's edema in women are not fully reversible with surgery and smoking cessation. One explanation would be the presence of possible structural alterations in fibroblasts caused by the toxicity of cigarette components, resulting in the uncontrolled production of fibrous matrix in the lamina propria, and preventing complete vocal recovery.
(Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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