Laryngoscopy should be performed to visualize the larynx and evaluate for vocal cord pathology in a patient whose hoarseness does not resolve within 3 months (SOR C). If a serious condition is suspected for some other reason, laryngoscopy should be performed regardless of the duration of symptoms. If there is a recent history of upper respiratory infection or vocal abuse, then it would be appropriate to recommend voice rest  for  2  weeks.  Laryngoscopy would  then be indicated  if the hoarseness  did not improve  or recurred after voice rest. For patients with symptoms of gastroesophageal reflux, a trial of a proton pump inhibitor is recommended (SOR B). Inhaled corticosteroids, especially fluticasone, may cause hoarseness. Oral corticosteroids do not have a role in the management of hoarseness.

Ref:     Feierabend RH, Shahram MN: Hoarseness in adults. Am Fam Physician 2009;80(4):363-370. 2) Schwartz SR, Cohen SM, Dailey SH, et al: Clinical practice guideline: Hoarseness (dysphonia). Otolaryngol Head Neck Surg 2009;141(3 Suppl 2):S1-S31.” ABFM

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