referral if laryngeal symptoms - referral from primary care

referral of patients with laryngeal symptoms

Persistence of laryngeal symptoms (without an obvious cause) beyond three weeks warrants laryngeal examination by an otolaryngologist

• a recent retrospective study reported that in patients who were referred to otolaryngologist with an initial diagnosis of acute laryngitis
  
  
• three quarters had a different final laryngeal diagnosis
• nearly half with laryngeal cancer had an initial diagnosis of either acute laryngitis or non-specific dysphonia.

The following symptoms should prompt an urgent referral to exclude malignancy.

• recent surgery involving the neck or recurrent laryngeal nerve
• recent endotracheal intubation
• radiotherapy to the neck
• history of smoking
• professional voice user (for example, singer, actor, teacher)
• weight loss
• dysphagia or odynophagia
• otalgia
• serious underlying concern by clinician (1)

Note that (2):

Reference:

• (1) Wood JM, Athanasiadis T, Allen J. Laryngitis. BMJ. 2014;349:g5827
• (2) NICE (June 2015). Suspected cancer: recognition and referral.