Reinke's layer seen in -

Reinke’s Edema It is diffuse edema of the Reinke’s space (of vocal cords) leading to irreversible fusiform swelling of the vocal cord—usually bilateral. Commonest etiology is smoking though extra esophageal reflux, vocal strain and hypothyroidism has also been implicated. Patient has a low-pitched hoarse voice; may present as stridor in severe cases. Treatment is superior cordotomy (incising the superior surface of vocal cord preserving the medical vibrating edge) through microlaryngoscopy to decompress the edema fluid. The mucosal flap is then replaced after trimming off the excess epithelium.