Vocal Fold Hemorrhage and Polyps Overview
13 Questions
0 Views

Vocal Fold Hemorrhage and Polyps Overview

Created by
@VersatileGoblin

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What characteristic distinguishes a hemorrhagic polyp from a typical nodule?

  • It cannot be treated surgically.
  • It appears dark and filled with blood in early stages. (correct)
  • It does not interfere with phonation.
  • It is always smaller than typical nodules.
  • What is the recommended behavior if a patient is taking anticoagulant medications and has a hemorrhagic polyp?

  • Increase the dosage of anticoagulants to manage bleeding.
  • Continue using all medications as prescribed.
  • Stop intake of anticoagulant medications if possible. (correct)
  • Immediately seek surgical intervention.
  • What is one possible treatment method for a small, early hemorrhagic polyp?

  • Immediate surgical removal.
  • Conservative measures with potential for complete resorption. (correct)
  • Regular use of anti-inflammatory medications.
  • Long-term use of corticosteroids.
  • What procedure may be appropriate if there is a recent large hemorrhage resembling a blood blister?

    <p>Microsurgical evacuation of the hematoma.</p> Signup and view all the answers

    In a long-standing hemorrhagic polyp, what should be done during surgical intervention?

    <p>Trim the polyp superficially while coagulating underlying large capillaries.</p> Signup and view all the answers

    What is the primary cause of vocal fold hemorrhage?

    <p>Shearing forces acting on capillaries during extreme vocal exertion</p> Signup and view all the answers

    Which facet of vocal capabilities is impacted by a unilateral hemorrhagic polyp?

    <p>The presence of a falsetto register</p> Signup and view all the answers

    What type of behavior most commonly predisposes individuals to unilateral hemorrhagic vocal fold polyps?

    <p>Intermittent severe voice abuse</p> Signup and view all the answers

    What is a common observation during a laryngeal examination of a patient with a hemorrhagic vocal fold polyp?

    <p>A largely unilateral lesion in the node position</p> Signup and view all the answers

    What can a deep capillary rupture in the vocal folds lead to?

    <p>An accumulation of blood similar to a blood blister</p> Signup and view all the answers

    What may chronic vocal overuse lead to in relation to a hemorrhagic polyp?

    <p>An acute injury superimposed on chronic nodules</p> Signup and view all the answers

    Which factor does NOT typically contribute to vocal fold hemorrhage?

    <p>Frequent use of corticosteroids</p> Signup and view all the answers

    What is a primary characteristic of vocal fold hemorrhage as it progresses?

    <p>Resolution of bruising may occur completely within 2 weeks</p> Signup and view all the answers

    Study Notes

    Vocal Fold Hemorrhage and Unilateral Hemorrhagic Vocal Fold Polyp

    • Epidemiology:
      • More common in men.
      • Occurs in individuals who engage in intermittent severe voice abuse or work in noisy environments.
      • Surprisingly few patients have a history of using aspirin or other anticoagulants.

    Pathophysiology and Pathology

    • Causes:
      • Shearing forces on capillaries during extreme vocal exertion leading to rupture.
      • Capillary ectasia increases susceptibility to injury.
    • Types:
      • Superficial:
        • Thin, widely spread superficial bruise without vocal fold margin convexity.
        • Little effect on mucosal oscillation.
        • Full resolution within 2 weeks.
      • Deep:
        • Focal blood accumulation, similar to a blood blister.
        • Alters margin contour and stiffens mucosa.
        • Causes significant and prolonged hoarseness.
        • May be the precursor of a hemorrhagic polyp.
    • Microscopic examination of hemorrhagic polyps:
      • Shows a rich vascular stroma and areas of hyalinization.
    • Unilateral, nonhemorrhagic, pedunculated polyps:
      • May be the end stage of a hemorrhagic polyp.

    Diagnosis

    • History:
      • Abrupt onset of hoarseness during extreme vocal effort (e.g., at a party, sporting event, or after a loud sneeze).
    • Vocal Capability Battery:
      • Varies depending on polyp size, age, turgidity, and pedunculation.
      • May present with intermittent and subtle aberrant sounds, impaired or absent falsetto register, or chronic vocal huskiness.
    • Laryngeal Examination:
      • Unilateral lesion in the node position.
      • Contact reaction or nodule on the fold opposite the polyp (in vocal overdoers).
      • Hemorrhagic polyp usually larger than a typical nodule, appearing dark and filled with blood in the early stages.
      • Discoloration may be at any stage of bruise evolution.
      • Long-standing hemorrhagic polyps may lose their vascular appearance and become pedunculated, moving in and out of the glottis with inspiration and expiration.
      • During phonation, the polyp may displace upward onto the fold's superior surface, minimally interfering with basic phonation.

    Treatment

    • Medical:

      • Discontinue anticoagulant medications (NSAIDs and warfarin) if possible.
      • Control acid reflux.
    • Behavioral:

      • Short course of voice therapy for voice care instruction.
    • Surgical:

      • Recent, large hemorrhage: Evacuation of blood through a tiny incision.
      • After microsurgical evacuation of hematoma: Interrupt large capillaries within Reinke's space.
      • Long-standing polyps: Superficial trimming and spot coagulation.
    • Prognosis:

      • Excellent for full return of vocal functioning after precision surgery.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Explore the epidemiology, pathophysiology, and pathology of vocal fold hemorrhage and unilateral hemorrhagic vocal fold polyps. Learn about the causes, types, and implications of these vocal conditions. This quiz is designed for those studying voice and speech pathology.

    More Like This

    Laryngeal Examination Techniques Quiz
    3 questions
    Benign Vocal Fold Disorders Overview
    10 questions
    Vocal Fold Mucosal Injury Quiz
    13 questions
    Vocal Fold Mechanics
    5 questions

    Vocal Fold Mechanics

    VersatileGoblin avatar
    VersatileGoblin
    Use Quizgecko on...
    Browser
    Browser