Reassessing the Role of Phonomicrosurgery and Smoking Status in the Management of Reinke's Edema

Abstract

ObjectivesTo elucidate recurrence patterns of Reinke's edema (RE) following phonomicrosurgery and compare current and former smokers' outcomes.MethodsA retrospective chart review was performed for patients who underwent microflap excision for RE at our institution since 2008. Patient data were collected, including demographics, smoking history, and operative and voice outcomes during the available follow‐up period. Descriptive statistics, student's t‐tests, Chi‐squared analyses, and Fischer's exact tests were used for the appropriate between‐group comparisons utilizing JMP statistical software.ResultsPatients who quit smoking on the day of surgery or continued to smoke postoperatively were included in our group of current smokers (n = 56). Patients who quit smoking within the month of surgery or longer were included in our group of former smokers (n = 22). There was no significant difference in postoperative voice outcomes between groups. Eight patients in the entire cohort experienced recurrence during the available follow‐up period. Fischer's exact test revealed no statistically significant association between smoking status and recurrence (two‐tailed p > 0.05). The mean time to recurrence for current smokers who did recur was 69 and 54 months for former smokers.ConclusionWe report low overall recurrence rates after microflap excision of RE lesions compared with historical data, without any significant difference in recurrence or voice outcomes when comparing current and former smokers. Further prospective trials with larger sample sizes are warranted to guide the surgical management of RE patients and the implications of smoking status.Level of Evidence.3 Laryngoscope, 2023