A vocal fold hemorrhage collection of blood within the vocal fold that occurs after rupture of a blood vessel. Vocal fold hemorrhage, even with a small amount of blood, weighs down the vocal fold causing voice changes. Singers and others who use their voice often who experience a sudden change in the voice should be concerned for a hemorrhage and evaluated immediately due to prevent long term damage.

Vocal fold hemorrhage occurs after a traumatic voice event such as:

  • Screaming or yelling
  • Singing loudly
  • Coughing
  • Voice overuse or misuse.

Symptoms of hemorrhage include:

  • Hoarseness
  • Rough voice
  • Vocal fatigue, or tiring with overuse


Diagnosis of vocal fold hemorrhage is made during laryngoscopy and stroboscopy. Diagnosis of a vocal fold hemorrhage is very important; if one continues to sing or talk with a hemorrhage, scarring of the vocal fold layers and permanent voice changes may occur.


A vocal fold hemorrhage is treated with voice rest. Hemorrhage can worsen if the voice is continually used, potentially causing irreversible vocal fold scar. Close follow up with laryngoscopy is important to ensure that the hemorrhage resolves.

At times, after the hemorrhage resolves an irregular vessel may be identified as the cause of a hemorrhage. Microlaryngoscopy and laser surgery may be used to ablate irregular vessels, preventing future hemorrhage from occurring.