Efficacy of microscopic laryngeal surgery combined with gastric acid inhibition in treatment of Reinke's edema

Abstract

Objective To investigate the efficacy of microscopic laryngeal surgery, otherwise known as microlaryngoscopy, combined with gastric acid inhibition in the treatment of Reinke's edema. Methods The clinical data of 47 Reinke's edema patients with pharynx reflux preoperatively in our department from April 2016 to December 2019 were collected and retrospectively analyzed. These patients were divided into 2 subgroups according to receiving gastric acid inhibition (n=27) or not (n=20). At the same period, 56 normal subjects (control group) were selected for examination and investigation. The changes of voice function and voice handicap index (VHI) score were compared and analyzed before and in 1, 3 and 6 months after surgery. Results Before operation, fundamental frequency (F0) was significantly lower, and fundamental frequency perturbation (jitter), noise/harmonic ratio (NHR) and amplitude perturbation (shimmer) were obviously higher in the patient group than the normal group (P < 0.05). At 3 and 6 months after operation, F0 was notably higher, while the levels of jitter, shimmer and NHR were remarkably lower in the acid inhibition subgroup than the non-acid inhibition subgroup, and significant differences were observed in above indicators between the former subgroup and the control group (P < 0.05). In 1, 3 and 6 months after operation, F0 was gradually increased and the other 3 voice acoustic indicators were decreased at a certain degree in the both subgroups, with hoarseness gradually reduced. In 1 month after operation, there were no statistical differences in above indicators between the 2 subgroups, but F0 was higher while NHR, jitter and shimmer were lower in the acid inhibition subgroup than the non-acid inhibition subgroup at 3 and 6 months (P < 0.05), though great differences were observed among the 2 subgroups and normal control. The scores of VHI in the patient group before operation were higher than those in the control group (P < 0.05). The patient group had significantly higher scores and total scores in VHI than the control group (P < 0.05). After operation, these scores were decreased gradually after operation, and there were no significant differences between the 2 subgroups at each time point. At 6 months, there was no significant difference among the 2 subgroups and the normal group. Conclusion Surgical treatment is very effective for Reinke's edema, and postoperative gastric acid inhibition therapy can accelerate voice recovery in the patients with pharynx and laryngeal reflux.

Keywords

• microlaryngoscopic surgery
• gastric acid inhibition
• reinke's edema
• pharynx and laryngeal reflux