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Clinical Practice Guideline: Hoarseness (Dysphonia)

Clinical Practice Guideline: Hoarseness (Dysphonia)

This guideline was published as a supplement in the March 2018 issue of Otolaryngology—Head and Neck Surgery.

The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm.

Update Leadership: Robert J. Stachler, MD (Chair), David O. Francis, MD, MS (Assistant Chair), Seth R. Schwartz, MD, MPH (Methodologist)

Guideline Update Group: Cecelia C. Damask, DO, German Paul Digoy, MD, Evelyn C. Granieri, MD, MPH, MSEd, Helene J. Krouse, PhD, RN, ANP-BC, CORLN, Scott J. McCoy, DMA, Daniel R. Ouellette, MD, Rita R. Patel, PhD, CCC-SLP, Charles W. Reavis, Libby Jo. Smith, DO, Marshall Smith, MD, Steven W. Strode, MD, MEd, MPH, Peak Woo, MD

This guideline is endorsed by:

American Academy Otolaryngic Allergy (AAOA)
Society of Otorhinolaryngology Head-Neck Nurses (SOHN)
National Association of Teachers of Singing (NATS)
National Spasmodic Dysphonia Association (NSDA)
American Broncho-Esophagological Association (ABEA)
American laryngological Association (ALA)
American Speech-Language-Hearing-Association (ASHA)
American Society of Pediatric Otolaryngology (ASPO)
American Academy of Pediatrics (AAP)
American College of Chest Physicians (ACCP)
American Academy of Physical Medicine and Rehabilitation (AAPM&R)

Affirmation of Value provided by:
American Academy of Family Physicians (AAFP)


For Physicians

For Patients

In 2012 the ABIM Foundation launched Choosing Wisely® with a goal of advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.

Choosing Wisely centers around conversations between providers and patients informed by the evidence-based recommendations.

Access the AAO-HNSF Choosing Wisely List of 10 Things Providers and Patients Should Question

Examination of the larynx with mirror or fiberoptic scope is the primary method for evaluating patients with hoarseness. Imaging is unnecessary in most patients and is both costly and has potential for radiation exposure. After laryngoscopy, evidence supports the use of imaging to further evaluate 1) vocal fold paralysis, or 2) a mass or lesion of the larynx.

For Media & Public