Bruise / hemorrhage, vocal fold (1 of 4)
Bruise, right vocal fold (left of image), estimated one week old, in combination with large polypoid vocal nodules. Note the yellowish discoloration, indicating partial breakdown of the hemoglobin (source of red color of blood) into hemosiderin as bruise is beginning to be cleared away.
Bruise / hemorrhage, vocal fold (3 of 4)
Bruise was allowed to resolve, and then patient underwent vocal fold microsurgery one week prior to this examination.
Bruise / hemorrhage, vocal fold (4 of 4)
Same patient, during phonation. Note the patient’s tendency to phonate with a gap between the folds, as though the vocal folds “remember” the early contact that used to require separation during voicing. This gap can be lessened through expert speech (voice) therapy.
Bruise / hemorrhage, vocal fold (1 of 2)
Bruise, left vocal fold (right of image), estimated three weeks old, in combination with vocal nodules, capillary ectasia. There is likely an ectatic capillary also on the same side, within the nodule, that is the source of the leaking of blood into the tissues. When the bruise first occurred, it would have been most evident in the area of the nodule. As time passes, the central part of the bruise typically resolves first, with the last area to disappear anterior and posterior, as shown here. Note also the faint yellowish discoloration of the left fold, indicating residual hemosiderin (breakdown products of blood in tissue).