Table 8.
Draft key action statements from the AAO-HNS guideline on hoarseness
| 1. Diagnosis: Clinicians should diagnose hoarseness in a patient with altered vocal quality, pitch, or effort that impairs voice or alters voice-related quality of life. |
| 2. Laryngoscopy: The clinician should visualize the larynx of a patient with hoarseness if there is concern of a serious underlying etiology [if possible, list specific criteria here instead of the vague term “concern of a serious underlying etiology]. |
| 3. Modifying Factors: Clinicians should assess the patient with hoarseness by history and/or physical examination for factors that modify management such as one or more of the following: immunocompromised state, prior laryngeal surgery, [list here, succinctly, all of the major factors; the list does NOT have to be completely inclusive]. |
| 4. Ancillary Testing: Clinicians should not obtain computed tomography (CT), magnetic resonance imaging (MRI), or electromyography (EMG) of the patient with a primary complaint of hoarseness prior to visualization of the larynx |
| 5. Laryngopharyngeal Reflux: Clinicians may/should/should not routinely prescribe antireflux medications in patients with hoarseness. |
| 6. Corticosteroid Therapy: Clinicians should not (routinely) prescribe [oral] corticosteroids to treat patients with hoarseness. |
| 7. Voice Therapy: (A) Clinicians should advocate voice therapy for patients diagnosed with hoarseness that persists longer than three weeks or is recurrent and reduces voice related quality of life. (B) Clinicians should/must visualize the larynx before prescribing voice therapy and document/communicate the results to the speech-language pathologist. |
| 8. Clinicians should not prescribe antibiotics for the treatment of hoarseness or laryngitis in the absence of concurrent bacterial infection. |
| 9. Clinicians should educate patients with hoarseness that surgery is a possible intervention. |
| 10. Clinicians may/should educate/counsel patients with hoarseness about control measures |
| 11. The clinician may/should prescribe botulinum toxin injections for the treatment of hoarseness spasmodic dysphonia. |