title: Vocal fold hemorrhage: factors predicting recurrence.
abstract: OBJECTIVE
  Vocal fold hemorrhage is an acute phonotraumatic injury treated with voice rest; recurrence is a generally accepted indication for surgical intervention. This study aims to identify factors predictive of recurrence based on outcomes of a large clinical series.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Retrospective review of cases of vocal fold hemorrhage presenting to a university laryngology service. Demographic information was compiled. Videostroboscopic exams were evaluated for hemorrhage extent, presence of varix, mucosal lesion, and/or vocal fold paresis. Vocal fold hemorrhage recurrence was the main outcome measure. Follow-up telephone survey was used to complement clinical data.
  
  
  RESULTS
  Forty-seven instances of vocal fold hemorrhage were evaluated (25M:22F; 32 professional voice users). Twelve of the 47 (26%) patients experienced recurrence. Only the presence of varix demonstrated significant association with recurrence (P = 0.0089) on multivariate logistic regression.
  
  
  CONCLUSIONS
  Vocal fold hemorrhage recurred in approximately 26% of patients. Varix was a predictor of recurrence, with 48% of those with varix experiencing recurrence. Monitoring, behavioral management and/or surgical intervention may be indicated to treat patients with such characteristics.
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, New York, U.S.A.
authors.forename: Christen J
authors.initials: CJ
authors.lastname: Lennon
authors.forename: Thomas
authors.initials: T
authors.lastname: Murry
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
mesh_terms: D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D007818:Laryngeal Diseases / Q000453:epidemiology*; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D014827:Vocal Cords
keywords: Vocal fold; hemorrhage; phonotrauma; varix; vocal fold paresis