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September 03, 2010

NPR on Muscle Tension Dysphonia aka (Hyper-)Functional Dysphonia


NPR reported on July 12, 2010 one woman's travail overcoming a raspy voice due to laryngeal hyperfunction (also known as muscle tension dysphonia). Voice therapy provided a cure for her condition.

I should state that muscle tension dysphonia (MTD) is NOT the same as spasmodic dysphonia and the two disorders are often confused with each other... and treated completely differently from each other.

MTD is when the muscles of the voicebox are too tight causing a raspy voice. This very commonly occurs after a viral laryngitis/cold. My (unsupported) hypothesis is that the brain tries to achieve a normal sounding voice in a setting of laryngitis where the voicebox is inflamed and swollen. This attempt at normalcy usually results in hyperfunction of the muscles composing the voicebox.

Unfortunately, once the laryngitis resolves, the patient is still locked into a mode of hyperfunctional voice use, even though there's no more need to do so. In essence, it has become muscle memory or a bad habit.

Voice therapy in its purest form tries to get the brain to revert back to a more normal muscle pattern while talking by essentially teaching the patient to break this bad habit. Whether that includes laryngeal massage as in the article or via specific vocal exercises, it depends on the patient. There is not one specific treatment that will work on everyone with this condition.

Spasmodic dysphonia is when specific muscles of the voicebox goes into spasm, much like people with eye twitches. It is involuntary and occurs at random without warning. Treatment for spasmodic dysphonia is botox injections. Voice therapy does play a limited role in allowing for a longer duration of botox effectiveness which typically wears off in about 3 months before repeat injection is required.

Read the NPR story here.

Read more about muscle tension dysphonia here.

Read more about spasmodic dysphonia here.

Of note, our clinic specializes in these disorders.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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