4
Key Points
Figure 1. Key Action Statement (KAS) Algorithm
Patient Presents with Hoarseness
Identify or Diagnose Dysphonia
KAS1
YES
KAS3
Do Not Image
KAS8
KAS4a
KAS5
NO
KAS6
YES
KAS7
NO
KAS12
Alarm
Symptoms*
or Professional
Voice?
KAS2
Escalation of Care
Do Not Prescribe
Anti-reflux Medications
Do Not Prescribe Steroids
Do Not Prescribe Antibiotics
Evaluation/Prevention
KAS4a/9a
Laryngoscopy or Referral
for Laryngoscopy
Improvement/
Resolution in
4 weeks?
KAS13
Document Improvement/
Resolution
Medical Management
Voice Therapy
Surgery
Botulinum toxin for
Laryngeal Dystonia
Education/Prevention
KAS6,7,8
KAS9b
KAS10
Triage and Treat Based on Findings
KAS11
KAS12
H&P to Evaluate Underlying Cause
*Examples of Alarm
Symptoms:
• Stridor (breathing
difficulties)
• Neck mass
• History of smoking
• History of anterior neck,
neurosurgical or thoracic
surgery
• Recent intubation
• Unexpected weight loss
• Concomitant dysphagia
or dyspnea
• Concomitant
neurological symptoms
(e.g., dysarthria)
