This course emphasizes critical, evidence-based review of current practice regarding laryngopharyngeal reflux with focus on improving patient care related to dysphonia - helping to answer the question, "If it's not LPR making my patient hoarse, then what is it?". Based on enthusiastic feedback from prior meetings, case-based discussion will focus on clinical management and will introduce various topics concerning the epidemiology, pharmacologic management, role of empiric treatment, and testing strategies for LPR. It will also offer insights into differential diagnosis for dysphonia beyond LPR, focusing on subtle pathologies that are often missed. Relative to LPR, current paradigms often yield uncertain diagnosis, while prolonged treatment and/or extensive testing are time-consuming and costly, have side effects, and yield equivocal benefit in many cases. Through focus on strengths/weaknesses of various diagnostic strategies and with knowledge of current practice patterns, this panel hopes to identify "best practices" for evaluation of presumed laryngopharyngeal reflux and offer suggestions for patient management of non-reflux causes of hoarseness. This presentation aims to recall Otolaryngologists to a broader patient-based perspective and refocus attention on better evaluation for complaints possibly related to laryngopharyngeal reflux.