What are the indications for referring a patient with laryngitis to an ENT specialist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Indications for referring a patient with laryngitis to an ear, nose, and throat (ENT) specialist include:

  • Persistent or unexplained hoarseness, especially in people aged 45 years and over, to exclude laryngeal cancer. Referral should be arranged using a 2-week suspected cancer pathway if lymphadenopathy is also present .
  • Presence of a neck lump or persistent cervical lymphadenopathy associated with laryngitis symptoms, which may warrant specialist assessment .
  • Symptoms suggestive of malignancy or complications such as persistent symptoms despite adequate treatment, or red flags like unexplained weight loss, dysphagia, or airway obstruction .
  • Severe or progressive symptoms that do not respond to initial management in primary care, or if there is suspicion of a serious underlying condition requiring specialist imaging or biopsy .

In summary, referral to ENT is indicated when laryngitis symptoms are persistent, unexplained, associated with risk factors for malignancy, or accompanied by neck lumps or other red flags suggestive of cancer or serious pathology .

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