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Hoarseness is a subjective term and usually refers to a weak or altered voice.


Consider possible causes:

  • acute laryngitis
  • hypothyroidism
  • 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.

GP Management

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

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