Hematoma

Description and Etiology

Within the vocal folds there are extremely small delicate blood vessels which extend across the various tissue layers.  A vocal fold hemorrhage is damage to the tissues as a result of exposure to blood.  When superficial layer of the lamina propria(second layer) is affected the effects can be devastating and produce substancial voice problems.  The causes of vocal fold hemorrhage include: traumatic behaviors or traumatic injury, complications associated with surgical or medical procedures, prolonged levels of high intensity voice, excessive crying, and use of anticoagulant(a substance that prevents the clotting of blood) may also increase the risk of hemorrhage.

  • Perceptual Signs and Symptoms

o      Voice problem

o      Complete aphonia

o      Hoarseness

o      Ranging from minimal/mild to complete loss of voice

  • Features of Visual Assessment

o      Area of patchy redness on the vocal fold surface

o      Possible effects:

§       Impaired vibratory motion of the affected vocal fold

§       Increased mass

§       Stiffness

§       Reduced vibratory characteristics

 

  • Management
    • Surgical removal of microvascular lesions may prevent a vocal fold hemorrhage
    • In the acute phase:

o      Complete and total voice rest in order allow the tissues time to heal

o      Once healed, residual voice problems can be treated through a variety of augmentative procedures

§       Injection of fat or collagen to the vocal fold to restore vibratory capacities