Consider possible causes:
- acute laryngitis
- vocal cord palsy
- benign lesion of larynx (polyp, nodule)
- malignant lesion of larynx
Hoarseness for more than three weeks qualifies for Two Week Wait referral, especially if a smoker or heavy drinker.
According to NICE guidelines such patients should first have a chest X-ray to pick out patients with lung cancer causing vocal cord palsy; such patients would be referred to Lung Two Week Wait.
Other patients, with hoarseness but normal chest x-ray, should go to Head/Neck Two Week Wait.
Intermittent hoarseness can be referred as routine ENT.
Please see right for a leaflet for patients advice on voice care.