Adele, the singer-songwriter, blogged today that she has been diagnosed with a vocal fold hemorrhage, and unfortunately has been forced to cancel her tour.

A vocal fold hemorrhage is, as Adele described, like a ‘black eye’ of the vocal fold. The vocal fold has many blood vessels within which normally are very small. In the case of a hemorrhage one of the vessels bursts causing blood to seep within the layers of the vocal fold. This can happen at a moment’s notice as a result of voice overuse, screaming, or even after a violent cough. The blood weighs down the vocal fold, making it unable to vibrate properly, causing voice changes and hoarseness. Vocal fold hemorrhages are bruises which take up to two weeks to fully resolve.

During an episode of hemorrhage it is best to maintain complete voice rest, as talking can cause more bleeding. Individuals are followed closely to ensure that the blood is completely absorbed before resuming voice use.

If one continues to use their voice during a period of hemorrhage, the vocal folds can scar causing permanent vocal fold damage. After resolution of the hemorrhage an individual is examined closely for any abnormal blood vessels which may be treated in-office with minimally invasive laser surgery.