54 - Reinke's crystals, Reinke's space and Reinke's oedema

Reinke's crystals are rod-shaped crystals in the interstitial cells of the testis and hilus cells of the ovary .


Reinke's space is seen in chronic laryngitis with swelling of the membranous part of the vocal cords .
This swelling of the vocal cords due to edema is also called Reinke's edema .  


These are named after Friedrich Berthold Reinke ( 1862-1919 ), who was an anatomist from France .


1q: What is Reinke’s Oedema?


Reinke’s Oedema is a fluid filled swelling of one or both of the vocal cords.
The quality of the voice is likely to be affected by Reinke’s Oedema. Speaking may become more difficult and sound breathy or rough. The pitch of the voice may sound lower than it used to. These changes can be gradual.


2q: Causes and risks : 


Reinke’s Oedema is most commonly associated with smoking. Some research shows a link with acid reflux and an under-active thyroid. It tends to affect women more than men.


3q: Diagnosing Reinke’s Oedema :


Usually an Ear Nose and Throat (ENT) doctor will examine the larynx (voice box) using a small flexible camera which goes through the nose ( flexible laryngoscope ) . This takes place in the outpatient’s clinic and does not require admission to hospital.If the ENT doctor suspects that an under-active thyroid is the cause of Reinke’s Oedema, they will arrange the appropriate tests.


4q: Treatments available :


The choice of treatment depends on the cause of Reinke’s Oedema.
• Surgery may be required to remove some of the fluid from the vocal cords.
• Speech and language therapy can help to improve vocal health and voice quality. speech and language therapist explains how to care for the voice and reduce vocal misuse and irritants.
• Medication to reduce acid reflux or balance the hormones produced by the thyroid gland if needed.
• Stopping smoking alone may result in Reinke’s Oedema subsiding.


5q: What a patient can do :


Looking after your voice, stopping smoking and reducing irritants can help the vocal cords to recover. Advice on how to do this will be given to you by the speech and language therapist. Advice sheets that are given to you should only be used under the direction and supervision of a qualified Speech and Language Therapist
If you continue to smoke and irritate your vocal cords after treatment, Reinke’s Oedema is likely to return.

eponyms in medicine - part 39

381 - Parinaud’s oculoglandular syndrome is preauricular node enlargement associated with chronic granulomatous conjunctivitis; atypical form of cat scratch disease from inoculation near eye.

382 - Reinke’s edema is vocal cord polyposis in female smokers - 50s-70s.

383 - Rosenthal fibers is inclusions that develop in astrocytes in chronic reactive and neoplastic proliferations; abundant in Alexander’s disease.

384 - Fontan procedure is for treating tricuspid atresia - pulmonary atresia - or hypoplastic left heart syndrome - procedure developed in 1968 whereby IVC is connected to pulmonary artery; long term complications include arrhythmias and protein losing enteropathy because of edema in liver and small bowel.

385 - Gleason score is prostate cancers stratified into 5 grades on basis of glandular patterns and degree of differentiation; grade 1 most differentiated and grade 5 no glandular differentiation; primary score and secondary score (for second most common histology) added together for score; therefore most differentiated tumor score of 2.

386 - Gianotti-Crosti syndrome is reactive exanthem - first described in association with hepatitis B infection (papular acrodermatitis of childhood - papular eruption on face and limbs); also associated with EBV - CMV infection.

387 - Naxos disease is initially described on Greek island of Naxos - synrome of arrhythmogenic right ventricular cardiomyopathy - non-epidermolytic palmoplantar keratoderma - and woolly hair - due to deletion in plakoglobin - protein in adherens and desmosomal junctions.

388 - Carney complex is AD complex of cardiac myxomas with aggressive biologic behavior - spotty pigmentation - and association with endocrine tumors (causing e.g. - Cushing syndrome); mutations in PRKAR1alpha gene (a protein kinase) account for half of the cases; unrelated to Carney syndrome.

389 - Klinger disease is Wegener’s disease; first described by Heinz Klinger in 1931 as a medical student and then described by Friederic Wegener in 1936.

390 - Paget’s disease of breast is breast cancer involving nipple and areola - appears as eczematous rash over breast with crusting - scaling - or erosion.