Does Thyroid Dysfunction Have a Role in the Etiology of Vocal Fold Edema?

BACKGROUND/OBJECTIVES: Previous studies have shown that hypothyroidism with myxedema may significantly affect the vocal folds. The aim of this study was to investigate thyroid dysfunction and other possible risk factors, including smoking, for the development of Reinke's edema (RE) in a group of men. METHODS: Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) were measured in a group of men with first occurrence or recurrent RE and in age- and gender-matched control subjects without laryngeal pathology. All participants completed a questionnaire on other possible etiologic factors for the development of RE, especially smoking. Risk factors were compared between the two groups. Levels of TSH and thyroid hormones were also compared between patients with recurrent disease and those with a first occurrence of RE. RESULTS: A total of 53 men with RE (mean age 53.82 years) and 45 controls (mean age 57.71 years) completed the study protocol. TSH and thyroid hormone levels were within the normal limits in all participants. Serum fT3 levels were significantly higher in patients with RE compared to controls (p = 0.034). After univariate analysis, all risk factors were included in a multivariate regression model. Only smoking remained a significant variable. Thyroid hormone levels did not differ between patients with first-onset RE and those with recurrent RE. CONCLUSIONS: An association between hypothyroidism and the development of RE was not confirmed. The significantly higher fT3 levels in patients compared to controls were still within the normal range and may reflect normal variation. Regression analysis of possible risk factors for RE showed the primacy of smoking.