Persistent hoarseness, a deepening voice, and shortness of breath may signal Reinke’s edema of the vocal cords, a condition often misdiagnosed as excessive heat or laryngitis. Anyone with these symptoms should have a laryngoscopy at the otolaryngology department as soon as possible.
Reinke’s edema is the abnormal accumulation of extracellular matrix in Reinke’s space between the vocal fold epithelium and the vocal ligament, causing diffuse swelling of the vocal cords due to chronic irritation.
It most often affects middle‑aged and elderly people, more common in men, while women typically develop a noticeably low, male‑like voice. The main causes are long‑term smoking (over 95% of cases), improper or excessive voice use, laryngopharyngeal reflux, and hypothyroidism.
Typical symptoms include hoarseness, low pitch, vocal fatigue, frequent throat clearing, and in severe cases, breathing difficulty or laryngospasm. Examination shows a greatly reduced fundamental frequency (F0) and translucent, belly‑like swelling of both vocal cords under laryngoscopy.
Treatment includes conservative measures (smoking cessation, antireflux therapy, voice rest and training, treatment for hypothyroidism) and laryngeal microsurgery when needed. Recurrence can be prevented by maintaining smoking cessation and correct vocal habits after surgery.
Overall, Reinke’s edema is a common benign vocal cord lesion closely linked to smoking, voice overuse, and reflux, requiring lifestyle and vocal habit correction plus possible microsurgery.