National guidelines for curing hoarseness released

The first national clinical practice guideline to assist healthcare practitioners in ascertaining and managing patients with hoarseness or dysphonia is scheduled to be released by the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF).

From Sciencedaily.com:

Key features of the new guideline include:
* Most, but not all, hoarseness is the result of benign underlying or self-limiting factors; however, clinicians should consider the possibility of a serious underlying condition (growth or tumor of the larynx) or medication side effects as a cause.
* Laryngoscopy is an office procedure to visualize the larynx (voice box and vocal cords) that should be performed if hoarseness persists or if the cause is uncertain.
* Imaging studies, such as a CT or MRI scans, should not be obtained for a primary complaint of hoarseness prior to visualizing the larynx; laryngoscopy is the primary diagnostic modality and should be done first.
* Anti-reflux medicines should not be prescribed for hoarseness unless there are (a) signs or symptoms of gastroesophageal reflex disease (GERD), such as heartburn or regurgitation, or (b) signs of inflammation of the larynx seen during laryngoscopy.
* Steroids or antibiotics given by mouth are not recommended for hoarseness and should not be used routinely.
* Voice therapy is a well-established intervention for hoarseness that can be performed at any age. Laryngoscopy should be performed prior to voice therapy and results communicated to the speech-language pathologist. Therapy for hoarseness usually includes one to two sessions per week for four to eight weeks.
* Surgery is not the primary treatment for most hoarseness, but may be indicated for suspected cancer, other tumors or growths, abnormal movement of the vocal cords, or abnormal tone of the vocal cord muscles.
* The risk of hoarseness may be reduced by preventive measures such as staying well-hydrated, avoiding irritants (especially tobacco smoke), voice training, and amplification during heavy voice use.

The guideline was developed by a multidisciplinary panel that represented neurology, speech-language pathology, professional voice teaching, family medicine, pulmonology, geriatric medicine, nursing, internal medicine, otolaryngology – head and neck surgery, pediatric medicine, and consumers.