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ENT · Laryngology
Sample itemA 55-year-old man who has smoked for decades has a low-pitched hoarse voice. Laryngoscopy shows bilateral symmetrical, translucent, sac-like swelling of the entire length of both vocal folds. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Reinke's oedema
Reinke's oedema is fluid accumulation in the subepithelial Reinke's space, strongly linked with smoking and voice abuse. It is bilateral and diffuse and produces a deep, rough voice. Stopping smoking is the first step, with microlaryngeal surgery for persistent cases.
Option by option
A. Glottic carcinoma
Glottic carcinoma is usually a unilateral, irregular or ulcerated lesion, not symmetrical translucent swelling.
B. Reinke's oedema (correct)
Correct. Diffuse bilateral polypoid swelling of the whole fold in a smoker is typical.
C. Recurrent respiratory papillomatosis
Papillomatosis produces warty, exophytic growths rather than translucent oedematous folds.
D. Vocal nodules
Vocal nodules are small bilateral lesions at the junction of the anterior and middle thirds and are seen in voice users.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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