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- Laryngoscopy should be performed to visualize the larynx and evaluate for vocal cord pathology in a patient whose hoarseness does not resolve within 3 months (SOR C).
- If a serious condition is suspected for some other reason, laryngoscopy should be performed regardless of the duration of symptoms.
- If there is a recent history of upper respiratory infection or vocal abuse, then it would be appropriate to recommend voice rest for 2 weeks.
- Laryngoscopy would then be indicated if the hoarseness did not improve or recurred after voice rest.
- For patients with symptoms of gastroesophageal reflux, a trial of a proton pump inhibitor is recommended (SOR B).
- Inhaled corticosteroids, especially fluticasone, may cause hoarseness.
- Oral corticosteroids do not have a role in the management of hoarseness.
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