What is Renk’s edema? The vocal folds are divided into supramucosal, superficial lamina propria, middle lamina propria, deep lamina propria, and muscularis. Renk’s gap is located between the mucosal epithelium of the vocal folds and the acoustic ligaments, one on each side, and is a potential gap that is the full length of the intermural free edge of the vocal folds. The main component of this gap is matrix protein without cellular structure, which is filled with loose connective tissue and few elastic fibers, making it very easy to form edema. Renk’s edema is a chronic, high degree of submucosal edema of the entire length of the vocal folds in the Renk’s layer, which may also involve the superior surface of the vocal folds or the laryngeal chambers. What are the common symptoms of Renk’s edema? 1. Hoarseness: It is the main clinical symptom, which can lead to loss of voice and low and monotonous tone when it is more severe. It is also accompanied by articulatory fatigue and foreign body sensation in the throat, which triggers frequent throat clearing symptoms. 2. Dyspnea: Severe edema causes both sides to lean together to block the anterior part of the vocal cords, leaving only the interarytenoid gap for breathing, making patients feel breath-holding and foreign body sensation, and experiencing varying degrees of dyspnea or even respiratory distress. How to check for Renk’s edema? The best means of examination is electronic laryngoscopy. Under the electronic laryngoscope, it is seen that the double vocal folds are swollen in the shape of fish belly, translucent, resembling the eyes of Longjing fish, the color is exactly the same as the vocal folds, the vocal folds are loose and sagging, edema and weakness, the surface is smooth, the swollen body reaches the anterior union and the posterior vocal fold protrusion, and some swelling is more obvious near the vocal fold protrusion. What is the cause of Renk’s edema? The cause of this disease is still unclear. It is generally believed that prolonged smoking and voice abuse can cause Renk’s edema. Improper use of sound, chronic irritation (fumes, dust, harmful gases, etc.), chronic diseases (nephritis, hepatitis, hypothyroidism), and other factors are also associated with Renk’s. What is the treatment for Renk’s edema? The treatment for Renk’s edema is surgical removal of the swollen tissue in the edematous Renk’s space. 1.epithelial debridement: direct microlaryngoscopic surgery under general anesthesia is performed using microscopic forceps and scissors to share the edematous tissue between its upper and lower boundaries, parallel to the free edge of the vocal cord, starting at the posterior aspect of the edema and removing the surface epithelium of the edematous vocal cord along with it. 2.Laser technique: The procedure is similar in approach and scope to epithelial avulsion, and the tissue to be removed is charred and vaporized by laser. 3.Microflap suction: After laryngoscopic exposure of the vocal folds, an incision is made on the surface of the vocal folds with microscissors, a separator lifts the epithelial microflap, and an aspirator or electric suction-cutting device removes the mucus matrix within the superficial lamina propria, preserving the normal or slightly larger portion of the superficial lamina propria adjacent to the middle lamina propria during suction to avoid damage to the needed superficial lamina propria and the vocal ligament. Occasionally, the mucus matrix of the superficial lamina propria becomes too viscous and is excised. After the volume of the superficial lamina propria has been reduced to the desired profile, the mucosal flap is repositioned to determine how much epithelium is needed to allow alignment of the mucosal cut edge, and the wound is compressed with a cotton swab soaked in 1/10,000 epinephrine hydrochloride to stop bleeding during the procedure. Postoperatively, the patient recovers more quickly and epithelial scar formation is less pronounced.