A hemorrhage occurs when one or more of the blood vessels in the vocal folds breaks open, filling the vocal fold and potentially forming a small ball or hemorrhagic polyp. It is caused by trauma to the vocal fold, such as extensive coughing or extensive screaming.

Overview and Symptoms

Symptoms of vocal cord hemorrhage can include:

  • hoarseness or roughness in your voice
  • tiring or fatigue after overusing your voice

During your first diagnostic visit, a speech pathologist will use a diagnostic tool called laryngovideostroboscopy to examine your vocal folds in slow motion.

On a second visit, a speech pathologist will collect acoustic measurements of your voice and have you participate in trial voice therapy techniques.


Recovery from a vocal fold hemorrhage usually requires a period of moderate or complete voice rest, followed by voice therapy and close monitoring of the hemorrhage.

Voice therapy is much like physical therapy for any other part of the body. Sessions usually take place weekly for about 8 visits. You'll learn about the basic anatomy and physiology of the voice mechanism and about how to care for your voice. Pre-surgical counseling is provided when appropriate.

To achieve the best results, we'll provide exercises to be completed at home. We will do our best to help you figure out how to fit these practice exercises into your daily schedule.

Through practice, the body learns to make the small changes required for effective voice activation and for a smoother, easier voice. Regular practice helps to make these changes automatic so that eventually they come naturally. You may find it helpful to record your voice therapy visit using you smart phone or other recording device to aid with home practice.

If you need surgery, voice therapy may occur either before or after surgery takes place. After, you will have a final voice re-assessment and laryngovideostroboscopy.

Care of the Professional Voice

Performers (such as singers, actors and broadcasters) and other professional voice users (such as teachers, clergy, and salespeople), rely on optimal function of their voices for their livelihoods. Appropriate care of the professional voice requires experience and training beyond basic voice diagnosis and therapy techniques. Our voice team has the specialized knowledge required to optimize and maintain voice quality.

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The Voice, Speech and Swallowing Therapy experts at BIDMC are nationally recognized leaders, specializing in the diagnosis and treatment of voice, airway, speech and swallowing conditions.

Voice, Speech and Swallowing Therapy