Ear, Nose & Throat

Vocal Cord Hemorrhaging – Symptoms, Remedies, Prevention

written by Becki Andrus

Most people take their vocal cords for granted until something happens that affects their voice. When you find it difficult to talk or sing, then you might be dealing with a vocal cord hemorrhage.

What Happens with a Vocal Cord Hemorrhage?

The vocal folds are located in the throat area. The “superficial lamina propria” is a thin layer of tissue that gives the vocal cords the vibrations needed for speech. These tissues are loosely arranged, and a relatively small disruption can affect the vibration of the vocal cord.

There are many layers of tissue in the vocal cords, with fine blood vessels throughout the area.

If there is bleeding that affects the superficial lamina propria, then it can interfere with speech. A small amount of blood can result in symptoms, so this type of hemorrhage is typically not life-threatening. Even when the bleeding stops, a small amount of blood remains on the vocal cords.

This blood gets trapped under the vocal cord’s layers and often causes the vocal cords to turn red. The blood is trapped inside, similar to a bruise on any other part of the body. The healing process is also similar to a bruise, with the tissue changing color while the blood is reabsorbed.

With a minor hemorrhage, the vocal cords might vibrate poorly. In moderate or severe cases, the vocal cord might be stiff and unable to vibrate at all.

Causes of Vocal Cord Hemorrhaging

Usually, a vocal cord hemorrhage is caused by trauma to the vocal cord tissue.

  • Physical Stress: It could be a physical stress from loud talking or singing, causing small blood vessels to break. For example, it’s common for a vocal cord hemorrhage to occur after cheering at a sports game or following a big musical performance.
  • Poor Technique: The way the vocal cords are used impacts the risk of a hemorrhage. If someone pushes through when they are sick or their voice is strained, it increases the likelihood of a vocal cord hemorrhage.
  • Daily Habits: Frequent throat clearing, shouting, or coughing can put undue pressure on the vocal cords and cause a hemorrhage.
  • Health Conditions: Certain health conditions can increase the likelihood of a hemorrhage. If you have laryngitis or polyps in the throat, there could be a higher risk of a hemorrhage.
  • Overuse: Vocal cord hemorrhages are most common among people who use their vocal cords professionally, such as sports coaches, singers, and teachers.
  • Medications: Certain types of prescription and over-the-counter medications can increase the risk of a vocal cord hemorrhage. The risk goes up if you are using aspirin, warfarin, clopidogrel, or blood thinners.

Some people have a one-time experience with a hemorrhage, while others have repeated bleeding that causes chronic symptoms.

Symptoms of a Hemorrhage in the Vocal Cords

If your vocal cords are hemorrhaged, then you will likely notice right away. Common symptoms include:

  • Hoarseness in the voice that develops quickly
  • Sometimes the hoarseness is noticeable while talking
  • Other times, the hoarseness only occurs while singing
  • Hearing two pitches when the voice is used
  • A flutter in the speech or singing
  • Decreased signing range
  • Difficulty holding a steady pitch while singing
  • Loss of voice
  • Voice is affected after a specific event that strained the vocal cords

Usually, there is no pain or discomfort from a vocal cord hemorrhage. Your throat will feel normal, without any difficulty breathing or swallowing.

Treatment Options for Vocal Cord Hemorrhaging

An ENT can identify the cause of your hoarse voice to determine if you have a vocal cord hemorrhage. With proper medical care, it’s possible to heal this condition quickly and effectively.

The first recommendation is immediate rest for your vocal cords – no talking or singing. Depending on the doctor’s suggestion, you may need to stop using the vocal cords entirely for a few days or drastically limit the use of your voice.

The exact length of vocal rest depends on the progress you are making in recovery. A follow-up appointment allows the ENT to see how the vocal cords are healing.

Voice therapy can be beneficial, especially for singers and other professionals that require rigorous use of their vocal cords.

Sometimes steroids are used to mask the symptoms for immediate relief. But it’s critical to note that covering up the symptoms will likely lead to more injury. Instead of hiding the symptoms with medication, it’s better to work with your doctor for an effective, long-lasting treatment plan.

When to Talk to an ENT about a Vocal Hemorrhage

A single instance of a hoarse voice from a vocal hemorrhage can often be treated with at-home rest and minimal use of the voice. If your profession requires the use of your vocal cords, or you find that the symptoms are recurring, then it might be time to talk to an ear, nose, and throat specialist.

Repeated occurrences could be a sign of an underlying cause. Your ENT doctor can help you get to the root of the issue. Then, you can heal your vocal cords and minimize the risk of symptoms in the future.

Chronic vocal cord hemorrhaging might happen because of improper use of the voice or a vocal cord irregularity that needs to be corrected.

When an irregularity is present and other treatments aren’t effective, your ENT might recommend a micro-laryngoscopy. This small surgery can address blood vessels prone to bleeding or repair any irregularities that increase the risk of broken blood vessels in the vocal cords.

Avoiding Vocal Hemorrhage Complications

Early diagnosis is best to avoid severe complications in the future. While most vocal cord hemorrhages heal on their own in a few days, it’s possible that a serious or chronic condition can cause long-term damage to the voice.

Potential complications of untreated vocal cord hemorrhaging might include:

  • Scarring
  • Permanent vocal hoarseness
  • Loss of vocal range
  • Pain when using the voice

If you are a singer or use your voice professionally, then an early diagnosis is key to protecting your voice. As soon as you notice that you are developing a hoarse voice, it’s essential to talk to an ENT. The hoarseness indicates that something is wrong – it’s not normal to have a hoarse voice after a performance!

People often delay treatment because they find that the hoarseness goes away when resting the voice after a performance. If the hoarseness is recurring and goes away with rest, then it’s an indication that the condition is reversible.

On the other hand, if you push through the hoarseness or the symptoms don’t go away, then it could be an irreversible problem with the vocal cords.

Professional Services from a Knowledgeable ENT

Rest assured, knowing that vocal hemorrhages are treatable in the early stages. In most cases, there is no permanent damage from the hemorrhage. If you want to protect your voice, then you should talk to an ENT for immediate treatment and prevention recommendations for the future.

At Collin County Ear, Nose, and Throat, we serve patients throughout the Collin County area. If your voice is hoarse, then we invite you to schedule an exam right away. We have offices in Frisco and Plano, TX, for your convenience. Request an appointment through our online form, or call if you would like to talk to our staff: (972) 596-4005.

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