Acute submucosal hemorrhage can occur in the vocal fold.


Clinical features:

(1) The patient has the onset of severe dysphonia (difficulty speaking).

(2) The patient reports an episode of screaming or other form of vocal abuse shortly before onset.

(3) An endoscopic examination shows swelling and erythema of the vocal fold.

(4) No other explanation is found.


The risk may be increased if the patient has a coagulopathy, including anticoagulation.


Usually the patient improves after simple voice rest. In severe cases the blood may need to be drained.


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