• 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.