Suggested Pre-Referral Evaluation and Management Guidelines
If associated with a URI, and is less than 4 weeks duration, treat conservatively per primary care physician.
If greater than 4 weeks duration, or associated with worrisome symptoms (odynophagia, dysphagia, hemoptysis, DOE, otalgia with normal exam, or weight loss), refer to Oto.
If pt is an occupational or professional voice user with significant voice difficulties, and no suspicion for neoplasm, consider referral to Multidisciplinary Clinic for Occupational and Professional Voice Users at the UM Vocal Health Center.
Suggested Additional Test/Management Prior to Specialty Visit
Complete narrative of onset.
Rule out obvious causes treatable by primary care provider.