Reinke's Edema - Smoker's Polyp

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Stroboscopic view at pitch A2 during mid closure. Both polyps being blown toward the viewer superior surface of the vocal cord, 5 weeks after surgery, 5 weeks after surgery. Stroboscopic view during mid closure.

History 57 year old female Complaints 20 years ago her voice began deepening. Now many of her clients think she is a man when on the phone with her. This is causing problems with her business. At times her voice actually stops and only air comes out. She cannot yell. She attributes the problem to a peritonsillar abscess and series of sore throats she had 20 years ago. Medical history Singing: was a soprano when young, no singing now Smoking: 1 ppd x 20 years Fluids: Water: 3 cup per day Caffeine: 5 caffeinated beverage/day Alcohol: 0 glass per month Character Talkativeness: 4 on a scale of 7 (1 quiet, 7 talkative) Loudness: 4 on a scale of 7 (1 is soft, 7 is loud) Vocal commitments at Work: 4 hours per workday Vocal capabilities See Vocal capabilities testing guidelines for explanations Reading pitch: low, monotonal Anchor pitch: F2 (yes, it is that low) Range: F2 – G3 Max phonation: >14 seconds @ C3 Loudness: soft yell Swelling tests: G3 marked air leak Neurogenicity: none Psychogenicity: none Valving: soft edge Respiration: normal Stroboscopic Examination of the Larynx

Treatment Surgical excision, with attention to preserving some of the lamina propria and prevent stiff vocal folds post operatively. Other photos of smoker’s polyps.