Youval Slovik, Aviad Sapir, Yotam Heilig, Oren Ziv, Chen Hazout, Yael Raviv, Oded Cohen
Surgical treatment of RSE can provide measurable improvements in inspiratory airflow, particularly in the supine position, consistent with relief of glottic-level obstruction. While these preliminary findings from a small cohort are primarily hypothesis-generating, they suggest that surgery may confer functional respiratory benefits. Future prospective studies with larger cohorts are required to establish the pilot study's findings.
OBJECTIVE: Reinke's space edema (RSE) is classically associated with dysphonia; however, when extensive, it may also compromise glottic airflow and contribute to respiratory symptoms. Its impact on objective respiratory function remains poorly characterized. This study aimed to evaluate the impact of surgical treatment for RSE on spirometry parameters, mainly those associated with upper airway and glottic function.
STUDY DESIGN: A retrospective pilot study.
METHODS: Patients who underwent surgical management of RSE at a tertiary medical center between January 2020 and December 2024, with available preoperative and postoperative spirometry performed in both the supine and sitting positions. Spirometry measurements included Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC, Peak Expiratory Flow (PEF), Peak Inspiratory Flow (PIF), and Maximum Inspiratory Flow at 50% of FVC (MIF50).
RESULTS: Eleven patients (10 women, 90.9%; mean age 61.8 ± 8.2 years) were included. All were heavy smokers (mean of 59 pack-years) with a history of long-standing disease. Significant postoperative improvements were observed in PIF in both sitting (2.47 ± 0.66 vs. 2.85 ± 0.62 L/s, P = 0.003) and supine (2.37 ± 0.79 vs. 3.11 ± 1.31 L/s, P = 0.028) positions; MIF50 supine (2.34 ± 0.86 vs. 2.98 ± 1.21 L/s, P = 0.046) and FEV1 in the sitting position (1.84 ± 0.41 vs. 1.92 ± 0.50 L, P = 0.042). No significant changes were observed in FVC, FEV1/FVC, or PEF.
CONCLUSIONS: Surgical treatment of RSE can provide measurable improvements in inspiratory airflow, particularly in the supine position, consistent with relief of glottic-level obstruction. While these preliminary findings from a small cohort are primarily hypothesis-generating, they suggest that surgery may confer functional respiratory benefits. Future prospective studies with larger cohorts are required to establish the pilot study's findings.