# Identification of Patients with Reinke’s Edema Through Biomechanical Voice Analysis

## TL;DR

This study shows that biomechanical voice analysis can help identify women with Reinke’s edema, a vocal fold condition, without needing direct laryngeal exams.

## Contribution

The study introduces biomechanical voice analysis as a novel screening method for Reinke’s edema with high sensitivity and specificity.

## Key findings

- Decreased F0 (Pr01), increased mucosal wave (Pr20), shortened closure phase (Pr04), and mass effect (Pr22) are key indicators of Reinke’s edema.
- Screening using F0 decrease and mucosal wave increase achieves 92% specificity and 77% sensitivity compared to the control group.
- The same screening method shows 93% specificity and 77% sensitivity when distinguishing Reinke’s edema from other vocal fold pathologies.

## Abstract

Background and objectives: Reinke’s edema is a benign disease of the vocal folds caused by smoking and excessive vocal effort that usually leads to chronic dysphonia, especially in women. Diagnosis requires direct evaluation of the vocal folds using videolaryngoscopy. Biomechanical analysis of the voice makes it possible to obtain from a sound sample a set of parameters that describe the pattern of voice production associated with the specific architecture of each vocal fold. The objective is to identify the characteristic vocal production pattern in Reinke’s edema while analyzing the validity of this methodology for screening the pathology. Methods: The study was performed with a sample of 175 women, from 26 to 74 years old, separated into 3 groups: Control Group, 52 participants; Reinke’s edema Group, 26 patients; Vocal Fold Pathology—no Reinke’s edema, 97 patients. All the patients were evaluated by the biomechanical analysis tool App Online Lab VCS® by Voice Clinical Systems®. Results: It is observed that a decrease in F0 (Pr01), an increase in the mucosal wave in the opening phase (Pr20), a shortened closure phase (Pr04) and the presence of mass effect (Pr22) are the main features that characterize Reinke’s edema compared to the control group with broad statistical significance (p < 0.001). These results establish that the screening based on the joint presence of the decrease in F0 (Pr01) and the increase in the mucosal wave effect (Pr18/Pr20) presents high sensitivity and specificity indices: Group control vs. Reinke’s edema, Specificity: 0.92, Sensitivity: 0.77; Reinke’s edema vs. Vocal Fold Pathology—no Reinke’s edema, Specificity: 0.93, Sensitivity: 0.77. Conclusions: Biomechanical voice analysis objectively identifies voice patterns in women with Reinke’s edema, aiding in effective screening.