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3 8. Antimicrobial erapy Clinicians should NOT routinely prescribe antibiotics to treat dysphonia. S-A against 9a. Laryngoscopy Prior to Voice erapy Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/ communicate the results to the speech-language pathologist. R-C 9b. Advocating for Voice erapy Clinicians should advocate voice therapy in patients with dysphonia from a cause amenable to voice therapy. S-A 10. Surgery Clinicians should advocate for surgery as a therapeutic option in patients with dysphonia with conditions amenable to surgical intervention such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. R-B 11. Botulinum Toxin Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. R-B 12. Education/ Prevention Clinicians should inform patients with dysphonia about control/preventive measures. R-C 13. Outcomes Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in quality of life in patients with dysphonia aer treatment or observation. R-C Table 1. Summary of Guideline Key Action Statements (KAS) (cont'd) Statement Action Strength

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