Before getting surgery in November, Adele had to cancel concert dates because of injured vocal cords. (Credit: adele.tv)

Singer-songwriter Adele will take the stage at the Grammys on Sunday, giving her first performance since she had surgery in November for a vocal cord hemorrhage. Though operations have saved several famous voices in recent years, doctors say going under the knife is often a last resort when it comes to repairing vocal cords.

A vocal cord hemorrhage like Adele's happens when tiny blood vessels feeding the vocal cords rupture and leak. Surgery can seal the blood vessels to prevent them from filling the vocal cords with blood, which make it difficult for them to vibrate.

Recovering from the surgery is no small matter, especially for a performer who needs a booming voice to sing for millions of people. Dr. Kristine Tanner, clinical director of the University of Utah Voice Disorders Center, said Adele has likely had full use of her voice since early January. Usually after surgery for a vocal hemorrhage, patients completely rest their voices for one week, begin speaking lightly  after two or three weeks and can gradually begin singing three to six weeks after surgery.

"Then you have to work back up to your previous endurance level, like going back to the gym after being out for six weeks," Tanner said.

Vocal cord problems are an occupational hazard for many professional singers, recently plaguing the likes of John Mayer and Keith Urban, both of whom went under the knife to save their voices.

Performers who belt out songs to sold-out arenas, record tracks for new albums and use their voice for day-to-day speaking can develop polyps and nodules on their  cords, keeping them from vibrating correctly when air passes over them. Doctors can detect these problems using imaging technology and scopes with cameras attached, and fix them with minimally invasive procedures, such as phonomicrosurgery.

But voice experts say surgery is often a last resort for a performer's vocal troubles. Dr. Michael Benninger, chairman of the Head and Neck Institute at the Cleveland Clinic, has treated dozens of celebrity singers and public speakers. He said most doctors recommend other types of treatments to correct patients' vocal troubles .

"We rarely have to do surgery on these patients," Benninger said. "It is surprising how many high-profile performers that we see that behavioral modification is what they need."

Formal vocal training, speech therapy, larynx massages and even changes in diet, alcohol use and other lifestyle habits can do a lot to alleviate exhausted, injured vocal cords, which can take as much of a beating as the muscles and bones of athletes. Often, these fixes are a better solution than surgery, Tanner said.

"It's like a runner. You can operate on their ankle, but it would be preferred to change their form so they don't continue to reinjure themselves," Tanner said.