Phonation-induced trauma of the vocal cords is a subepithelial hemorrhage at the edge of the vocal cords caused by high mechanical stress, such as intense and/or loud vocalization. Typically, the surface of the vocal cord (the epithelium) becomes detached from the lamina propria and protrudes forward. This leads to reduced vocal performance and hoarseness.

Etiology and Pathogenesis:

The main cause is excessive mechanical strain on the vocal cords, such as screaming.

Symptoms:

• Hoarseness

• Diplophonia (double voice)

• Foreign body sensation

• Irritative cough

• Frequent throat clearing

Diagnosis:

The clinical diagnosis can be reliably confirmed through stroboscopic examination using HD (High Definition) technology.

Treatment:

Conservative: Spontaneous improvement of the condition is possible. Vocal rest is crucial. Inhalation with NaCl (saline) can be helpful.

Surgical: If the condition does not improve spontaneously (hemorrhage beneath the vocal cord epithelium), a surgical approach is recommended. The surgical removal can be performed under local anesthesia, if needed, with the use of a blue laser/KTP laser or under general anesthesia. We recommend subsequent speech therapy to learn the gentle use of the vocal cords.

Here is an example before and after treatment:

Experience Report: Vocal Cord Hemorrhage

(very competent and friendly doctor • Age: over 50 • Insurance: public health insured)

I immediately felt very well taken care of by him. He explains everything in a very understandable manner and is also very empathetic during the rather uncomfortable examination. His friendly nature helps alleviate some of the fear patients may have about unpleasant examinations.

Both before and after the surgery, everything was explained and shown to me in a clear manner. There is a very well-functioning appointment system. Scheduled appointments are honored, and you are seen promptly. You can also sense a good collaboration between him and the reception nurses. All in all, he is an excellent doctor who knows what he's doing, and I highly recommend him.