2
Key Points
Table 1. Summary of Guideline Key Action Statements (KAS)
Statement Action Strength
Diagnosis
1. Identification of
Abnormal Voice
Clinicians should identify dysphonia in a patient
with altered voice quality, pitch, loudness, or vocal
effort that impairs communication or reduces
QOL.
R-C
2. Identifying
Underlying Cause
of Dysphonia
Clinicians should assess the patient with dysphonia
by history and physical examination for underlying
causes of dysphonia and factors that modify
management.
R-C
3. Escalation of Care Clinicians should assess the patient with
dysphonia by history and physical examination
to identify factors where expedited laryngeal
evaluation is indicated. ese include but are not
limited to: recent surgical procedures involving
the head, neck or chest, recent endotracheal
intubation, presence of concomitant neck mass,
respiratory distress or stridor, history of tobacco
abuse, and whether he/she is a professional voice
user.
S-B
4a. Laryngoscopy
and Dysphonia
Clinicians may perform diagnostic laryngoscopy
at any time in a patient with dysphonia.
O-C
4b. Need for
Laryngoscopy
in Persistent
Dysphonia
Clinicians should perform laryngoscopy, or refer
to a clinician who can perform laryngoscopy,
when dysphonia fails to resolve or improve within
4 weeks, or irrespective of duration if a serious
underlying cause is suspected.
R-C
5. Imaging Clinicians should NOT obtain computed
tomography (CT) or magnetic resonance imaging
(MRI) in patients with a primary voice complaint
prior to visualization of the larynx.
R-C against
Treatment
6. Anti-Reflux
Medication and
Dysphonia
Clinicians should NOT prescribe anti-reflux
medications to treat isolated dysphonia, based
on symptoms alone attributed to suspected
gastroesophageal reflux disease (GERD) or
laryngopharyngeal reflux (LPR), without
visualization of the larynx.
R-B against
7. Corticosteroid
erapy
Clinicians should NOT routinely prescribe
corticosteroids in patients with dysphonia prior to
visualization of the larynx.
R-B against
