Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Favorite

Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 4 - Laryngology/Broncho-Esophagology

Evaluating Dysphonia Referrals to Otolaryngology Providers: Is There a Need for Improved Referral Guideline Implementation?

Tuesday, October 14, 2025

10:24 AM - 10:30 AM EDT

Location: 120

Disclosure(s):

Rishi Kondapaneni, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kaitlyn R. Florence, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Dysphonia arises from diverse etiologies and requires timely, accurate diagnosis. In 2018, the AAO-HNS updated dysphonia management guidelines. Notably, these updates recommended referral for ongoing dysphonia after four weeks, compared to the previous recommendation of three months, and avoidance of several interventions before laryngeal exam. This study assesses progress in adherence to these guidelines among referring providers.

Methods: We conducted a retrospective chart review of adult patients referred to our department for dysphonia from 1/1/2015 to 12/31/2022. Data on patient demographics, referring provider information and clinical history was collected. Management practices of referring providers were compared before and after the 2018 guideline update. A chi-square analysis was performed to assess the proportion of patients who were managed in accordance with the updated guidelines.

Results: Of 533 patients, 141 were referred before and 392 after the release of 2018 updated guidelines. Only 52% of patients referred following release of 2018 guidelines were managed in accordance with the guidelines by the referring provider. Referrals post-2018 guideline release exhibited decreased adherence to the following guidelines (p < 0.05): referral for dysphonia within 4 weeks, avoiding imaging before laryngeal visualization and avoiding corticosteroid use before laryngeal visualization. There was no significant improvement in adherence to any key action guideline in the post-publication group. Patients diagnosed with URI by referring providers were significantly less likely to have timely referrals and more likely to have antibiotic and corticosteroid prescriptions (p < 0.05).

Conclusions: Providers referring dysphonic patients to our institution only follow AAO-HNS dysphonia guidelines 52% of the time, a percentage that has paradoxically worsened since their publication in 2018. Certain risk factors, such as pre-existing URI symptoms, contribute to inappropriate pre-referral management. More effective communication of updated guidelines to non-otolaryngologists is warranted.

Presenting Author(s)

Rishi Kondapaneni, BS

Medical Student
University of Missouri School of Medicine
Dardenne Prairie, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Kaitlyn R. Florence, MD

Resident Physician
University of Missouri-Columbia School of Medicine-Dept. Of Otolaryngology-Head and Neck Surgery
Columbia, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

ES

Erika Shock, BS

University of Missouri School of Medicine, United States

Disclosure information not submitted.
NH

Nicole A. Henry, BS

Medical Student
University of Missouri School of Medicine
Columbia, MO, United States

Disclosure information not submitted.
Megan E. Price, BS

Medical Student
University of Missouri School of Medicine
Columbia, MO, United States

Disclosure information not submitted.
Logan M. Mays, BS

Medical Student
University of Missouri School of Medicine
SPRINGFIELD, MO, United States

Disclosure information not submitted.
JB

Jeffrey L. Bodeen, BS

Medical Student
University of Missouri School of Medicine
Columbia, MO, United States

Disclosure information not submitted.
BG

Bin Ge, PhD

University of Missouri-School of Medicine-Dept. Of Biomedical Informatics, Biostatistics, and Medical Epidemiology, United States

Disclosure information not submitted.

Co-Author(s)

ED

Eric Y. Du, MD MPH

Resident Physician
University of Missouri Department of Otolaryngology-Head and Neck Surgery
Columbia, MO, United States

Disclosure information not submitted.

Senior Author(s)

MG

Mark R. Gilbert, MD

Assistant Professor of Otolaryngology
University of Missouri-Columbia School of Medicine-Dept. Of Otolaryngology-Head and Neck Surgery
Columbia, MO, United States

Disclosure information not submitted.