Return to Vocal Performance After Vocal Fold Hemorrhage.

Objective: Although vocal fold hemorrhage (VFH) is a common injury among vocal performers, no evidence exists to guide safe return to performance (RTP). This study assesses VFH recurrence following RTP.

Study design: Retrospective cohort.

Setting: Academic institution.

Methods: Adult vocal performers with clearly documented dates of VFH and of RTP were retrospectively studied. Clinicodemographics, interventions, and recurrence of VFH within 30 days of RTP were noted. Cohorts with and without recurrence were compared.

Results: Thirty-two patients (median age: 36 years, 49% female, 76% musical theater performers) with 33 unique occurrences of VFH were included. Most hemorrhages (31; 94%) were unilateral. Twelve patients (36%) had varices, all of which were ipsilateral to the hemorrhage. Overall, median time from initial VFH to RTP was 12.0 days (range 3-29). Two patients (6%) had a recurrence within 30 days of RTP. Median time to RTP was 10 days for those with recurrence and 12 days for those without recurrence (P = .6398). There were no differences in age (37 vs 34 years; P = .8206), sex (0 vs 16 [49%] female; P = .4848), extent of hemorrhage (P = .1728), or presence of associated varices (1 [50%] vs 11 [35.5%]; P > .9999) between groups.

Conclusion: Rate of VFH recurrence following RTP at a median of 12 days after initial injury was 6%, regardless of age, sex, hemorrhage extent, or associated varices. Although the interval between VFH and RTP was shorter in patients with recurrence, this was not statistically significant. These findings guide counseling and set expectations among vocal performers faced with VFH.

Level of evidence: IV.