Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Evidence-Based Medicine

Background:

• Dysphonia, affecting nearly one-third of the population, is characterized by altered vocal quality impacting communication and quality of life.
• Existing guidelines require updates to incorporate new evidence and ensure optimal patient care across all age groups.
• A multidisciplinary panel was convened to provide comprehensive, evidence-based recommendations for dysphonia management.

Purpose of the Study:

• To provide clinicians with evidence-based recommendations for the diagnosis and treatment of dysphonia.
• To reduce inappropriate variations in care and improve health outcomes for patients experiencing voice alterations.
• To establish a framework for decision-making in dysphonia management, prioritizing patient well-being and minimizing harm.

Main Methods:

• Systematic review of current evidence on dysphonia diagnosis and treatment.
• Development of Key Action Statements (KASs) based on expert consensus and evidence profiles.
• Inclusion of patient preferences and multidisciplinary perspectives in guideline formulation.

Main Results:

• Strong recommendations for prompt laryngeal evaluation in patients with risk factors and for voice therapy when indicated.
• Recommendations for surgical intervention, botulinum toxin injections, and patient education on preventive measures.
• Strong recommendation against routine antibiotic use and against non-visualized imaging or empiric medication for isolated dysphonia.

Conclusions:

• Clinicians should utilize a structured approach to diagnose and manage dysphonia, prioritizing laryngeal visualization.
• Voice therapy and surgical options should be considered for appropriate conditions, guided by evidence.
• The guideline aims to standardize care, improve patient outcomes, and provide a transparent decision-making framework.