RISK-FACTORS AND MANAGEMENT OF VOCAL CORD HEMORRHAGES - AN EXPERIENCE WITH 44 CASES

Risk factors for vocal cord hemorrhages were reviewed in 44 professional voice users. In a majority of cases, the direct cause of hemorrhage was temporally related to singing, public speaking, or some form of forceful laryngeal activity. Sixteen of the 44 patients had a concomitant upper respiratory tract infection, and in the case of women patients, eight of 30 had hormonal imbalances. These included abnormal menstrual cycles, use of estrogen supplements, gynecological surgery, and the use of birth control pills. In most of these cases, correction of the underlying hormonal disturbance prevented the recurrence of bleeding episodes. We stress that such abnormalities should be ruled out by history and appropriate tests when necessary, to prevent the occasional crippling sequelae of vocal cord hemorrhages and review the various treatment options available for this condition.