Reviewed on : 4 Aug 2014

Reviewed by : Peter Dekker, Consultant ENT Surgeon

Expires : 4 Aug 2016

 Assessment

Consider possible causes:

• Acute laryngitis
• Hypothyroidism
• Vocal cord palsy
• Benign lesion of larynx (polyp, nodule)
• Malignant lesion of larynx

Referral

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.

GP Management

Please see right for a leaflet for patients advice on voice care.