Long-term consequences of vocal fold hemorrhage

Abstract

To assess the long-term impact of vocal fold hemorrhage (VFH) on vocal function and health, and compare these parameters to those in similar patients who have not had VFH. Retrospective cohort study. Patients with a history of VFH (N = 41) were characterized through a review of records and assessed by means of a survey for vocal health and professional functioning as well as the Voice Handicap Index-10 (VHI-10) and, if appropriate (n = 30, 73.2%), the Singing Voice Handicap Index (SVHI-10). They were compared to a group of demographically and occupationally similar patients without VFH (N = 25, 60.9%). Patients with multiple episodes of VFH (n = 9, 22.0%) were compared to patients with a single event. After a median of 41 months follow-up, patients with VFH had favorable vocal function assessment and low median VHI-10 and SVHI-10 scores (4 and 6, respectively), substantially similar to patients without VFH (VHI-10, P = .905 and SVHI 10, P =.991). The two groups showed similarly low rates of change in occupation (7.3%vs. 8.0%, P =.999). Patients with VFH were more likely to have missed days of work due to a voice problem. Analysis of patients with one versus multiple VFH episodes showed no differences, except patients with multiple episodes had significantly greater confidence in their ability to address future VFH. Contrary to commonly held belief, VFH appears to have no significant long-term impact on vocational stability, subjective voice quality, or perceptions of vocal function. Moreover, among those with VFH, recurrence seems only to diminish anxiety over this transient injury. 4 Laryngoscope, 127:900-906, 2017.