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Reinkes Oedema (polypoid degeneration of vocal cords)

It is bilateral symmetrical swelling of the whole of membranous part of vocal cords.
It is due accumulation of fluid under the epithelium of the true vocal cords i.e. subepithelial space also called Reinke’s space.

Etiology  Chronic irritation due to
  1. Infection (chronic sinusitis)
    1. Misuse of voice          
    2. Smoking            
    3. Laryngopharynges reflux  
    4. Allergy
Clinical features:
  1. Age group: 30-40 yrs (middle age)
  2. Vocal cords: bilaterally symmetrical, fusiform-swelling slightly translucent
  3. Hoarseness of voice is the presenting symptoms
  1. Surgery: Microlaryngeal surgery (Stripping/decortication of vocal cord)
  2. Voice rest
  3. Speech therapy
Angioneurotic oedema:
Recurring attacks of local swelling in various part of the body especially face, larynx, extremities and buttocks

  1. Allergic
  2. Non- allergic
    1. Hereditary
    2. Non - hereditary
Angioneurotic oedema of allergic type:
  1. Is accompanied by urticaria
  2. Present as allergic reaction of food, medicines/ inhaled allergens (ACE inhibitors)
  3. Treatment: anti allergies & steroids.
Hereditary Angio-Oedema:
  1. Non- allergic type
  2. Autosomal dominant
  3. Caused by deficiency of C1- esterase inhibitor protein (inhibitor of complement activation,   kinin system and fibrinolysis)
  4. Triad
    1. Abdominal pain
    2. Peripheral non-pitting oedema
    3. Laryngeal oedema
  • Acute attack: Treatment 36,000 U of C1 INH I.V
  • Long-term prophylaxis: Fibrinolytic inhibitor [E.A.C.A] and Tranexamic acid

Extra Edge. Angio oedema. Deficiency of C1 esterase inhibitor causes angio-oedema. Deficiency of this inhibitor causes increased production of C1 esterase. This leads to anaphylatoxins which cause capillary permeability and edema. Deficiency of C1 esterase inhibitor is an inherited condition.

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