RT Journal Article SR Electronic T1 Hoarseness: When to observe and when to refer JF Cleveland Clinic Journal of Medicine JO Cleve Clin J Med FD Cleveland Clinic SP 475 OP 481 DO 10.3949/ccjm.90a.23010 VO 90 IS 8 A1 Ferraro, Ellen L. A1 Nelson, Rebecca Chota A1 Bryson, Paul C. YR 2023 UL http://www.ccjm.org/content/90/8/475.abstract AB The terms hoarseness and dysphonia are used interchangeably, and both describe a type of altered vocal quality affecting one-third of patients. While hoarseness may be secondary to benign conditions such as reflux or viral laryngitis, it may suggest benign or malignant vocal-fold pathology. It is important for caregivers to know how to evaluate, treat, and when to refer patients for direct visualization via laryngoscopy. In this article, we review basic laryngeal anatomy and function, symptoms of vocal-fold pathology, and current guidelines from the American Academy of Otolaryngology–Head and Neck Surgery on the diagnosis and treatment of dysphonia, including patient referral.