Treatment of Recurrent Vocal Fold Hemorrhage in Ehlers-Danlos Syndrome

Abstract

Objectives:

Ehlers-Danlos syndrome (EDS) is a heterogeneous group of inherited connective tissue disorders. Generalized tissue and vascular fragility underlie many physical findings and resultant complications from the syndrome. We present a patient with vascular subtype of EDS with recurrent vocal fold hemorrhage who underwent successful treatment by microflap excision and CO2 laser ablation of true vocal fold microaneurysm. This is the first case report of a successful therapeutic laryngeal intervention for an EDS patient.

Methods:

Case report of one patient at a single institution.

Results:

A patient with hemorrhagic polyp after intubation underwent standard microscopic direct laryngoscopy and excision of a hemorrhagic polyp on her right true vocal fold. Hemorrhage recurred, and the patient underwent repeat microflap excision with identification of and CO2 laser ablation of a vocal fold microaneurysm. The patient experienced resolution of hemorrhage with resolution of dysphonia.

Conclusions:

This case report, the first documented therapeutic intervention for a vocal fold abnormality in EDS, highlights not only the care that should be taken when intubating patients with EDS but also the importance of considering additional measures needed to prevent recurrence of hemorrhage in patients with this connective tissue disorder.