Silent vocal fold hemorrhage

October 31, 2012
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Laryngoscopic Clinic

Although most vocal fold hemorrhages resolve spontaneously, accurate and timely diagnosis permits the laryngologist to prescribe precautions that will prevent further damage. This is especially important for patients who use their voices in their professions.

An 80-year-old woman presented with complaints of imbalance. Routine mirror laryngoscopy revealed a striking asymmetry in the color of her true vocal folds. The patient denied current or previous symptoms of dysphonia or odynophonia. Strobovideolaryngoscopy demonstrated a hemorrhage along the entire length of the superior surface of the right musculomembranous fold and hemosiderin staining at the anterior commissure (figure 1). The mucosal wave and amplitude were preserved, which is atypical in the setting of extensive hemorrhage.

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