Why does Adele have voice problems?

Adele, the British singer posted on her blog unfortunate news that she has had to cancel her tour because of she has been diagnosed with a vocal fold hemorrhage.

Adele accurately described a vocal fold hemorrhage is, as  a 'black eye' of the vocal fold.  The vocal fold has many blood vessels within which normally are very small.  A hemorrhage is when 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, especially as it hardens, making it unable to vibrate properly.  This causes voice changes and hoarseness.  Vocal fold hemorrhages are bruises which take up to two weeks to fully resolve.

Complete voice rest is recommended during an episode of hemorrhage, 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.

John Mayer

John Mayer, on September 16, 2011,  blogged that he has been diagnosed with a vocal fold granuloma which has caused him to cancel his signing engagements and postopone the release of his next album.

A vocal process granuloma is inflammatory tissue located adjacent to the vocal folds.  Located on the back portion of the vocal folds, granulomas prevent full closure of the vocal folds.  When large, granulomas cause symptoms including hoarseness and difficulty speaking or singing.  Granulomas occur due to numerous causes, including voice overuse, acid reflux from the stomach, recent cough, or even after surgery in which a breathing tube is placed between the vocal folds.

Granulomas are diagnosed during laryngoscopy, in which an otolaryngologist uses a small camera through the nose or mouth to view the vocal cords and larynx.

While granulomas, are not cancer, they are very difficult to cure.  Those with granulomas are often placed on voice rest and are asked to use their voices only when absolutely necessary.  If acid reflux from the stomach is determined to be a contributor, acid reflux medication and dietary changes are employed. 

Injections to the granuloma with steroid may be helpful in decreasing the swelling and reduce the size of the granuloma.  In fact, inhaled steroids, similar to those used for asthma may help as well. Lasers, including KTP and PDL, in the office may be used to decrease the size of the granuloma. 

Surgery for granulomas unfortunately is usually not sucessful.  Although a granuloma may easily be removed, it often returns weeks to months later. 

For more information, visit: http://www.throatdisorder.com/articles/john-mayer-diagnosed-granuloma