Laryngoscopy Criteria
(+) risk factors (smoking, heavy alcohol use, or long-standing gastroesophageal reflux disease) Hoarsness > 2 weeks = Laryngoscopy
(-) risk factors Hoarsness > 3 months = Laryngoscopy.

ITE 2013, Q64
A 45-year-old male presents with a 3-month history of hoarseness. He denies any other complaints and has not been ill recently. He is not on any medication, has no history of chronic medical problems, and does not smoke cigarettes or drink alcohol.
Which one of the following would be the most appropriate management of this patient?
A) Voice rest for 1 month
B) Laryngoscopy
C) A trial of a proton pump inhibitor
D) A trial of inhaled corticosteroids
E) Oral corticosteroids

ITE 2012, Q66.
A 52-year-old male comes to your office with a 2-month history of hoarseness that began with the onset of a head cold. His other symptoms resolved but the hoarseness has continued. He has smoked for 32 years and drinks 4 beers per day, and has had gastroesophageal reflux disease (GERD) for several years.
Which one of the following would be most appropriate at this point?

A) Voice rest
B) Laryngoscopy
C) Upper endoscopy
D) Inhaled corticosteroids
E) High doses of a proton pump inhibitor