Adele to have surgery to treat vocal cord hemorrhage. What is it?

Fans of the British pop star Adele were greeted with some sad news Friday, prompted by the singer’s ongoing problems with her vocal cords:

“It is with deep regret that Adele has been forced to cancel her remaining live dates and promotional appearances in 2011,” reads the statement on her website. “She is to undergo surgery to alleviate the current issues with her throat and a full recovery is expected. As a result, doctors have ordered her to rest her voice and completely recuperate before looking to schedule any work commitments.”

But laryngitis isn’t usually this devastating.

First, a little background from the Mayo Clinic. The vocal cords are “two folds of mucous membrane covering muscle and cartilage. Normally your vocal cords open and close smoothly, forming sounds through their movement and vibration. But in laryngitis, your vocal cords become inflamed or irritated. This swelling causes distortion of the sounds produced by air passing over them. As a result, your voice sounds hoarse. In some cases of laryngitis, your voice can become almost undetectable.”

Adele has battled laryngitis for much of the year, and this isn’t the first time she’s had to cancel shows due to health problems. On her blog, Adele describes two episodes when her voice “suddenly switched off like a light! it was literally as if someone pulled a curtain over my throat.”

Treatment for laryngitis is usually simple: Rest. If the vocal cords aren’t used, the swelling has a chance to go down.

But Adele apparently progressed to a vocal cord hemorrhage, a more serious condition involving bleeding. According to this fact sheet from the American Academy of Otolaryngology — Head and Neck Surgery, “vocal cord hemorrhage results when one of the blood vessels on the surface of the vocal cord ruptures and the soft tissues of the vocal cord fill with blood. It is considered a vocal emergency and is treated with absolute voice rest until the hemorrhage resolves.”

The Voice Care Center at Duke University adds that “a hemorrhage left untreated or occurring repeatedly may result in scarring of the vocal folds, which is a condition that is much harder to treat and has permanent effects on voice quality.”

In some cases, a hemorrhage can produce a polyp, or blood blister, on the vocal cords that doesn’t go away. In such cases, the polyp can be removed with microlaryngoscopic surgery. Doctors use a laryngoscope to see the vocal cords, and microscopic instruments are inserted through the mouth, according to this explainer from the Voice Medicine website, maintained by an otolaryngologist at Weill Medical College of Cornell University in New York. Though no incisions are made in the skin, general anesthesia is required for the one-hour procedure.

Adele herself never mentions surgery in her lengthy blog post updating fans on her health. However, she tells her fans this: “I have absolutely no choice but to recuperate properly and fully, or I risk damaging my voice forever. … My voice is weak and I need to build it back up.”