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    • CHFT: HOARSE VOICE IN ADULTS PATHWAY ←Click to view pathway image

      Source of image goes here

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    • Non-sinister features include a history of:

      • Occupational voice user
      • Vocal abuse
      • Steroid inhaler use
      • Recent respiratory tract infection

      Check thyroid status

      *No, and after 4 weeks of persistent hoarse voice
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    • CONSIDER URGENT REFERRAL TO ENT UNDER 2 WEEK WAIT

      • Voice care - provide patient information leaflet
      • Optimise steroid dose, device and technique
      • Hydration - reduce caffiene and alcohol, have regular sips of water
      • Anti-reflux measures if appropriate including Gaviscon qds +/- PPI
      • Chest X-ray if lung pathology suspected

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      Follow-up 6-8 weeks or sooner if any worsening symptoms

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    • REFER TO ENT CLINIC

    • NO FURTHER INTERVENTION