(0820) Inpatient Dysphonia Consults: Comparing Trends and Outcomes Relative to Intubation

Introduction: Dysphonia commonly prompts inpatient otolaryngology (ENT) consultation during hospitalization. This study examines the incidence of voice-related inpatient ENT consults at a tertiary care center, assessing rates of outpatient follow-up, intervention, and symptomatic improvement in relation to intubation history.

Methods: A retrospective chart review of all adult inpatient ENT consults from October 1, 2022 to October 1, 2023 at a tertiary care center was performed. We identified voice-related consults (hoarseness, dysphonia, etc.), excluding those with airway symptoms. Voice-related consults were further classified into post-extubation (PE) and non-post-extubation (NPE). We examined rates of outpatient follow-up, symptom progression, and outpatient interventions, including specialist referrals, imaging, or operative procedures. All outpatient follow ups were seen by a fellowship trained laryngologist.

Results: Of 975 inpatient ENT consults, 66 (6.8%) were voice related. After classification, the PE group contained 32 patients (48.5%) and the NPE group 34 patients (51.5%). The PE cohort had a 32.3% outpatient follow-up rate, of which 40% required further evaluation such as speech therapy or imaging, and 2 patients received vocal fold (VF) injections. Notably, 80% reported vocal improvement at follow-up. The NPE group had a 28.6% follow-up rate, 60% required therapeutic intervention, and 1 patient received a VF injection. Follow-up and intervention rates did not significantly differ between the cohorts (p = 0.871 and p = 0.371, respectively).

Conclusions: Our study explores long-term trajectories of voice-related inpatient ENT consults, focusing on extubation status. The American Academy of Otolaryngology – Head and Neck Surgery suggests laryngoscopy if dysphonia does not resolve within 4 weeks or if a serious underlying condition is suspected. Yet, entities like post-extubation posterior glottis stenosis presents risks, highlighting the need for refined clinical pathways to triage the urgency of ENT evaluation and follow-up.