Hoarseness: An approach for the general practitioner

Hoarseness is a common presenting complaint that can be difficult to assess and treat in the general practitioner's rooms. This is because of the large number of differential diagnoses and the ability to perform only a limited examination without direct visualisation of the area. An important skill is to be able to identify the patients of concern who may require urgent referral to an otorhinolaryngologist.

The aims of this article are to outline the basic assessment of the patient presenting with hoarseness; ascertain which patients require specialist referral; and discuss treatment for some benign causes of hoarseness.

Hoarseness can be a diagnostic dilemma and therefore difficult to treat. Vocal hygiene and speech therapy are valuable treatment tools for many benign conditions. Any patient with red flag features on history, or persistent hoarseness, should be referred to an otorhinolaryngologist.