Overview
Vocal cord hemorrhage involves bleeding within or around the vocal cords, often due to trauma or underlying vascular abnormalities, leading to potential airway compromise and voice dysfunction 4.Diagnosis
Clinical Presentation: Symptoms include hoarseness, throat pain, and in severe cases, stridor 13.
Diagnostic Tests: Laryngoscopy (direct or transcutaneous laryngeal ultrasound) is essential for visualization and assessment 1.
Grading: Not explicitly detailed in provided abstracts; typically assessed based on severity and impact on airway 4.Management
Initial Management: Reassurance, sedation if airway compromised, and avoidance of vocal strain 2.
Pharmacological Treatment: Anti-reflux medication to manage gastroesophageal reflux contributing to hemorrhage 23.
Surgical/Interventional: Carbon dioxide laser cauterization or cold instrument excision for vascular malformations like ectasias and varices 4.
Rehabilitation: Speech therapy to address functional issues post-treatment 34.Special Populations
Postoperative Patients: Paradoxical vocal cord motion can occur post-thyroidectomy, managed with speech therapy and observation 3.
Comorbidities: Gastroesophageal reflux noted as a contributing factor; anti-reflux therapy recommended 23.Key Recommendations
Utilize transcutaneous laryngeal ultrasound for vocal cord assessment post-training, proficiency typically achieved after approximately 42 examinations (Evidence: Moderate 1).
For paradoxical vocal cord motion, prioritize psychological intervention and anti-reflux therapy alongside reassurance (Evidence: Weak 23).
In cases of recurrent vocal fold hemorrhage associated with vascular malformations, consider cold instrument excision or laser cauterization for effective management (Evidence: Moderate 4).References
1 Wong KP, Lang BH, Lam S, Au KP, Chan DT, Kotewall NC. Determining the Learning Curve of Transcutaneous Laryngeal Ultrasound in Vocal Cord Assessment by CUSUM Analysis of Eight Surgical Residents: When to Abandon Laryngoscopy. World journal of surgery 2016. link
2 Lo HI, Ho HC, Hwang JH. Paradoxical vocal cord motion--a case report. Auris, nasus, larynx 2005. link
3 Harbison J, Dodd J, McNicholas WT. Paradoxical vocal cord motion causing stridor after thyroidectomy. Thorax 2000. link
4 Hochman I, Sataloff RT, Hillman RE, Zeitels SM. Ectasias and varices of the vocal fold: clearing the striking zone. The Annals of otology, rhinology, and laryngology 1999. link