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Functional Disorders of the Voice
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Muscle tension dysphonia (MTD) is primarily the result of vocal misuse or poor vocal technique.1, 2 In these cases, psychological factors are considered negligible or secondary. Furthermore, Morrison and Rammage4 describe different types of MTD (based on endoscopic appearance) but with the understanding that they all arise from laryngeal muscle tension during phonation. They further suggest that psychological factors are important only insofar as they influence autonomic arousal.
Voice assessment in the out-patient department
Published in Declan Costello, Guri Sandhu, Practical Laryngology, 2015
The clinician should note excessive, or reduced, tension in the jaw and temporomandibular joints, facial muscles and the extrinsic and intrinsic laryngeal muscles. Palpation for evaluation and treatment of muscle tension dysphonia is common in many clinics. A wide literature describes how muscular tension abnormalities can influence voice production. There are a number of diagnostic, assessment and treatment protocols relating to muscular tension and common palpation sites.4,9,13–15
Ear, nose and throat (ENT)
Published in Janesh K Gupta, Core Clinical Cases in Surgery and Surgical Specialties, 2014
Chris Coulson, Adrian Drake-Lee
Examination of the neck is usually uneventful. A flexible nasendoscopy in the clinic may show how the vocal apparatus is working and whether there are any lesions on the vocal cords. Singers’ nodules are a sign of vocal misuse and occasionally a unilateral vocal cord polyp may be found. Bilateral diffuse oedema suggests chronic persistent abuse but may be found in conditions such as thyroid disease. In patients with laryngopharyngeal reflux the posterior larynx appears inflamed. Muscle tension dysphonia is a common problem in professional voice users and leads to insufficient adduction of the cords on phonation.
Diagnostic vocal fold injection as an intervention for secondary muscle tension dysphonia
Published in Hearing, Balance and Communication, 2021
Christopher D. Dwyer, Thomas L. Carroll
Muscle tension dysphonia (MTD) encompasses a common unifying symptom of many voice disorders that manifest with excessive tension of the intrinsic and extrinsic laryngeal muscles during phonation. The term ‘muscular tension dysphonia’ was first introduced in 1983 by Morrison and colleagues [1,2]. It has become accepted that MTD represents not a single, distinct voice disorder, but rather includes a spectrum of disturbed vocal fold behaviours with multiple potential contributing etiologies and concurrent pathologies. Patients report a variety of laryngeal and voice symptoms as a result of this excess tension including a rough and strained vocal quality, pitch instability, odynophonia, vocal fatigue, vocal effort and globus sensation [3]. It represents an important contributing diagnosis in upwards to 40% of patients presenting to voice clinics [4].
Walking the thin white line – managing voice in the older adult
Published in Speech, Language and Hearing, 2019
The aged voice is often perceived as sounding weak or low volume, with a breathy quality (Kost & Sataloff, 2018; Rapoport, Menier, & Grant, 2018). Pitch elevation may occur as a compensatory strategy to assist in vocal fold contact. Vocal instability and roughness are also more prevalent (Johns et al., 2011). Muscle tension dysphonia may also occur secondarily, as a compensatory mechanism, and may create a rough overlay to the voice. Typically male and female voices slowly decrease in pitch (Johns et al., 2011). Tremor may occur and overlay other perceptual changes either in isolation or as part of a generalized tremor disorder (Kost & Sataloff, 2018). Voice-related effort and discomfort can be reported by patients with avoidance of noisy environments leading to social isolation (Johns et al., 2011).
Determining pain in patients with voice disorders: a qualitative study
Published in Logopedics Phoniatrics Vocology, 2021
Seyed Abolfazl Tohidast, Banafshe Mansuri, Rasool Bagheri, Hadi Azimi
The PWVDs reported that sometimes they had experienced pain after long-time speaking or voice use. This time of pain experience was mentioned mostly by the PWVDs who were professional voice users. One of the patients with primary muscle tension dysphonia, teaching as a university lecturer, mentioned that: “After talking to my students in the classroom for a long time, I feel a lot of pain and pressure in my larynx and my neck.” (P-18)