Elastic Fibers in Reinke's Edema

• Published in: Annals of otology, rhinology & laryngology Vol. 119; no. 9; pp. 609 - 614
• Main Authors: Sakae, Flavio Akira, Imamura, Rui, Sennes, Luiz Ubirajara, Tsuji, Domingos Hiroshi, Mauad, Thais, Nascimento Saldiva, Paulo Hilário
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.09.2010; Annals Publishing Compagny; SAGE PUBLICATIONS, INC
• Subjects: Basement Membrane - pathology; Biological and medical sciences; Coloring Agents; Elastic Tissue - pathology; Female; Humans; Laryngeal Edema - pathology; Laryngeal Mucosa - pathology; Male; Medical sciences; Middle Aged; Mucous Membrane; Otorhinolaryngology. Stomatology; Resorcinols; Rosaniline Dyes; Smoking - adverse effects; Vocal Cords - pathology; Voice Disorders - pathology; Voice Quality - physiology; elastic fiber; vocal fold; Reinke's edema; lamina propria; Edema; s: elastic fiber; Lamina propria; Elastic fiber; ENT; Vocal cord
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/000348941011900907

Objectives We describe the distribution of elastic system fibers in the superficial layer of the lamina propria of Reinke's edema, as compared with normal vocal folds. Methods Weigert's resorcin-fuchsin stain after oxidation with 10% oxone was used to study the arrangement of elastic fibers. The findings were categorized and afterward compared with the severity of Reinke's edema. Results Analysis of 20 specimens of vocal folds with Reinke's edema showed that the network of thin elastic fibers in Reinke's space lost their undulated appearance and had a tangled aspect. In addition, these fibers were no longer parallel to the epithelial basement membrane, but had a random distribution scattered throughout Reinke's space. The elastic fiber network immediately below the epithelial basement membrane also appeared more fragmented in Reinke's edema because of some alteration in organization combined with the 5-μm-thick histologic sectioning plane. No significant difference in the degree of elastic system fiber disarrangement was observed between severity grades II and III (p = 0.382). Large areas of disarrangement were predominant (80% of cases). Conclusions The disarrangement of elastic fibers in Reinke's edema may cause insufficient tissue resistance and resilience, contributing to the hypermobility observed in Reinke's edema.