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Organic and functional lesions: nodules, polyps and Reinke's edema

BACKGROUND: vocal nodules, vocal polyps and Reinke's edema are the most common benign organic lesions resulting from vocal misuse or abuse. PURPOSE: to conduct a comparative study about the normal vocal folds and the benign organic lesions, nodules, polyps and Reinke's edema. The study was performed using a literature review in indexed journals at Science Direct, Capes, LILACS, SciELO, MedLine and Scopus and books from 1999 to 2010. CONCLUSION: the distribution of extracellular matrix components of the proper lamina of the mucosa, elastic fibers, collagen fibers, hyaluronic acid and fibronectin is altered in all three disorders. There is a change in vibratory characteristics concerning amplitude, mucosal wave velocity and symmetry of vibratory pattern due to presence of increased mass in the vocal cords, contrary to what is seen in vocal cords with no disorder. Perceptual-auditory signal of vocal quality found is hoarseness, followed by breathiness and roughness (except for Reinke's edema), during speech production. In Reinke's edema, considerable reduction of voice fundamental frequency was also present. In all three lesions, there might be an incomplete glottal closure, but in Reinke's edema, depending on lesion symmetry, there may be complete glottic closure. As far as etiology is concerned, incorrect uses prevailed; as to incidence, nodules and Reinke's edema were predominant in females, and polyps were more frequent in males.

Vocal Cords; Larynx; Voice Disorders; Dysphonia; Voice


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