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

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.