Evaluation of a voice disorder usually proceeds by steps – a person pursues more specialized care the more stubborn and resistant to treatment a problem is. For hoarseness that comes with a cold or flu, it is perfectly appropriate to bring it to the attention of a primary-care physician. Most such cases resolve with treatment of the underlying illness. Hoarseness that lasts more than two or three weeks should be evaluated by a physician trained to examine the vocal folds and larynx, namely, an otolaryngologist .

The next degree of specialization is that of a laryngologist. Laryngology, the field of medicine that concerns itself with voice disorders, is a subspecialty of ear, nose and throat medicine. Whether or not a voice problem requires the expertise of a laryngologist depends on its nature, and the degree to which a given otolaryngologist feels comfortable handling the disorder.

The field of laryngology, as a stand-alone specialty, is relatively new. As a result, there is no examination or test that certifies a laryngologist. Initially, otolaryngologists developed a specialization in voice disorders by virtue of interest and experience. Nowadays, physicians generally pursue a course of additional study, called a fellowship, devoted to voice disorders following completion of their training in general otolaryngology. Fellowship training is a good sign that your otolaryngologist has an expertise in voice disorders, although more senior physicians will have trained before fellowships were available. Memberships in appropriate professional societies and publications in medical journals and textbooks dealing with voice disorders are also helpful signs.

At minimum, then, the physician evaluating your voice problem should be a board-certified otolaryngologist. He or she should be comfortable discussing various aspects of your disorder, and explain the problem and proposed treatments in terms that you understand. With the information presented in this site, you should be in a reasonably good position to judge whether the information you are being given makes sense. Note, though, that there are differences of opinion within the field, so physicians may view specific problems somewhat differently than they are presented here.

More information, including a means of searching for an otolaryngologist in your area, is available at the website of the American Academy of Otolaryngology – Head & Neck Surgery: www.entnet.org

How will the doctor determine what is wrong?

How are the vocal folds and larynx examined?