scholarly journals The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Seyyedeh Maryam Khoddami ◽  
Noureddin Nakhostin Ansari ◽  
Farzad Izadi ◽  
Saeed Talebian Moghadam
Keyword(s):  
Muscle Activity ◽  
Muscle Tension ◽  
Surface Emg ◽  
Assessment Methods ◽  
Voice Disorder ◽  
Laryngeal Muscle ◽  
Muscle Tension Dysphonia ◽  
Muscular Tension ◽  
Clinical Methods ◽  
Physiological Information

The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD.

scholarly journals Intractable Muscle Tension Dysphonia Treated by Injection Laryngoplasty and Lidocaine Injection

2021 ◽  
Vol 32 (2) ◽  
pp. 94-97
Author(s):  
You Young An ◽  
Jun Yeong Jeong ◽  
Ki Nam Park ◽  
Seung Won Lee
Keyword(s):  
Gold Standard ◽  
Muscle Tension ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Voice Therapy ◽  
Voice Disorder ◽  
Injection Laryngoplasty ◽  
Muscle Tension Dysphonia ◽  
Lidocaine Injection ◽  
Botox Injection

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

Updates on Vocal Tremor and its Management

2012 ◽  
Vol 22 (3) ◽  
pp. 97-103 ◽  
Author(s):  
Julie Barkmeier-Kraemer
Keyword(s):  
Neurological Disorders ◽  
Botulinum Toxin Type A ◽  
Muscle Tension ◽  
Botulinum Toxin Type ◽  
Voice Disorder ◽  
Behavioral Modification ◽  
Periodic Modulation ◽  
Pharmaceutical Treatment ◽  
Muscle Tension Dysphonia ◽  
Vocal Tremor

Vocal tremor is a neurogenic voice disorder characterized by a nearly periodic modulation in pitch and loudness during sustained phonation. This voicing pattern is the result of tremor affecting structures within the speech mechanism, resulting in modulation of lung pressure, phonation, articulation, and resonance during speaking. Speaking patterns in these individuals may be perceived as similar to spasmodic dysphonia or muscle tension dysphonia. The key to determining the presence of vocal tremor and distinguishing it from other voice disorders requires familiarity with the perceptual, acoustic, and physiologic patterns associated with vocal tremor during different voicing and speech contexts. Management of those with vocal tremor can be challenging because of its co-occurrence with other neurological disorders. The two most common methods for managing vocal tremor include pharmaceutical treatment, most commonly applied via injections of Botulinum Toxin Type A (Botox®), and behavioral modification of speaking patterns. The latter approach is in early clinical phases of research and has not yet been subjected to clinical trials. In this paper, I will summarize the clinical characteristics of vocal tremor in comparison to what is known about tremor in general and describe Botox® and behavioral approaches for managing individuals with this voice disorder.

Role of Surface EMG in Diagnostics and Treatment of Muscle Tension Dysphonia

1998 ◽  
Vol 118 (5) ◽  
pp. 739-743 ◽  
Author(s):  
I. HOCEVAR-BOLTEZAR ◽  
M. JANKO ◽  
M. ZARGI
Keyword(s):  
Muscle Tension ◽  
Surface Emg ◽  
Muscle Tension Dysphonia

Exploring the Clinical Utility of Relative Fundamental Frequency as an Objective Measure of Vocal Hyperfunction

2016 ◽  
Vol 59 (5) ◽  
pp. 1002-1017 ◽  
Author(s):  
Nelson Roy ◽  
Rebecca A. Fetrow ◽  
Ray M. Merrill ◽  
Christopher Dromey
Keyword(s):  
Fundamental Frequency ◽  
Muscle Activity ◽  
Clinical Utility ◽  
Muscle Tension ◽  
Objective Measure ◽  
Vowel Context ◽  
Muscle Tension Dysphonia ◽  
Vocal Hyperfunction ◽  
Before And After ◽  
Relative Fundamental Frequency

Purpose Vocal hyperfunction, related to abnormal laryngeal muscle activity, is considered the proximal cause of primary muscle tension dysphonia (pMTD). Relative fundamental frequency (RFF) has been proposed as an objective acoustic marker of vocal hyperfunction. This study examined (a) the ability of RFF to track changes in vocal hyperfunction after treatment for pMTD and (b) the influence of dysphonia severity, among other factors, on the feasibility of RFF computation. Method RFF calculations and dysphonia severity ratings were derived from pre- and posttreatment recordings from 111 women with pMTD and 20 healthy controls. Three vowel–voiceless consonant–vowel stimuli were analyzed. Results RFF onset slope consistently varied as a function of group (pMTD vs. controls) and time (pretherapy vs. posttherapy). Significant correlations between RFF onset cycle 1 and dysphonia severity were observed. However, in many samples, RFF could not be computed, and adjusted odds ratios revealed that these unanalyzable data were linked to dysphonia severity, phonetic (vowel–voiceless consonant–vowel) context, and group (pMTD vs. control). Conclusions RFF onset appears to be sensitive to the presence and degree of suspected vocal hyperfunction before and after therapy. The large number of unanalyzable samples (related especially to dysphonia severity in the pMTD group) represents an important limitation.

scholarly journals Voice Therapy in Muscle Tension Dysphonia Cases

2015 ◽  
Vol 5 (1) ◽  
pp. 20-24
Author(s):  
Smrity Rupa Borah Dutta
Keyword(s):  
Treatment Approach ◽  
Laryngopharyngeal Reflux ◽  
Muscle Tension ◽  
Professional Life ◽  
Voice Therapy ◽  
Medical College ◽  
Muscle Tension Dysphonia ◽  
Vocal Polyp ◽  
Muscular Tension ◽  
Post Therapy

ABSTRACT Muscle tension dysphonia (MTD) is a condition where phonation is associated with excessive muscular tension or muscle misuse. It has multifactorial etiologies. It can be a primary or secondary MTD. While it can affect anyone, sufferers usually belong to a particular group. It has very serious impact on sufferer's personal, social and professional life. We are presenting here, our 20 months prospective study done in the department of otorhinolaryngology, Silchar Medical College and Hospital from June 2012 to July 2013. Voice therapy was given to every patient, whether primary or secondary MTD. Pre-therapy vs post-therapy comparisons were made of self-ratings of voice handicap index, auditoryperceptual ratings as well as visual-perceptual evaluations of laryngeal images. Outcome of voice therapy results (Graphs 1 and 2) in such patients were found to be very good. As the disease is multifactorial, treatment approach should be broad-based involving multidisciplinary team. Abbreviations Vocal Cord Nodule (N), Vocal Polyp (P), Laryngopharyngeal Reflux (LPR), Presbylaryngis (PL), Cut Throat injury (CT), Primary Muscle Tension Dysphonia (PMTD), Dysphonia Plica ventricular (DPV). How to cite this article Singh SP, Dutta SRB. Voice Therapy in Muscle Tension Dysphonia Cases. Int J Phonosurg Laryngol 2015;5(1):20-24.

scholarly journals Application of manual therapy in muscle tensional dysphonia

2021 ◽  
Vol 18 (1) ◽  
pp. 20-28
Author(s):  
Stevan Jovanović ◽  
Slađana Arsić ◽  
Biljana Stojanović-Jovanović ◽  
Dragana Kljajić ◽  
Marija Trajkov
Keyword(s):  
Manual Therapy ◽  
Repeated Measures ◽  
Muscle Tension ◽  
Voice Disorder ◽  
Therapeutic Effects ◽  
Small Pilot Study ◽  
Muscle Tension Dysphonia ◽  
Vocal Qualities ◽  
Before And After ◽  
Control Study

Muscle tension dysphonia is a functional voice disorder caused by unbalanced activity of the laryngeal and extralaryngeal muscles. People with dysphonia may have changes in the cervical and perilaryngeal muscles, limited amplitude of movement of the cervical spine, but also posture disorders. The aim of this paper is to present the analyzed therapeutic effects of manual techniques in muscle tension dysphonia, based on a review of the available literature. In accordance with the set criteria and the goal of the paper, the collection and analysis of professional and scientific research papers available in PubMed / MEDLINE databases and others, published in the period from 2004 to 2018, was performed. The analyzed studies belong to the type of clinical studies and by design, two types of studies are included: the type of randomized control study and the study of one group of subjects with before and after-examination. Some studies with one group of respondents were characterized by the authors as a series of cases and one, as a small pilot study of repeated measures. The results of the research indicate a larger number of corrective effects of laryngeal manual therapy. It is certain that by developing a broader manual-therapeutic approach, the etiological factor of muscle tension dysphonia can be more effectively influenced which leads to a reduction in pain, improvement of physical functioning as well as improvement of specific vocal qualities.

Muscle Tension Dysphagia Evaluation and Treatment

2020 ◽  
Vol 5 (6) ◽  
pp. 1593-1597
Author(s):  
Christina H. Kang ◽  
David G. Lott
Keyword(s):  
Muscle Tension ◽  
Concurrent Disorders ◽  
Laryngeal Muscle ◽  
Muscle Tension Dysphonia ◽  
Therapy Technique ◽  
Assessment And Treatment ◽  
High Treatment ◽  
Vocal Fold Motion ◽  
Critical Aspects

Purpose This clinical focus article introduces primary and secondary muscle tension dysphagia (MTDg) as a functional idiopathic dysphagia that is often encountered in the otolaryngology clinic setting. Critical aspects of clinical assessment and treatment approaches will be discussed. The presented case study will describe a multidisciplinary evaluation and efficacy of therapy. Conclusions MTDg is a diagnosis of exclusion for a functional idiopathic swallowing disorder associated with abnormal laryngeal muscle tension. Abnormal laryngeal muscle tension is often associated with disorders of laryngeal hyperresponsiveness such as muscle tension dysphonia, chronic cough, globus pharyngeus, and paradoxical vocal fold motion. MTDg patients may exhibit concurrent disorders of laryngeal hyperresponsiveness. Proper dysphagia and gastroesophageal screening are critical in diagnosis of MTDg and must not be omitted. Our studies have shown high treatment efficacy with unloading of laryngeal muscle tension with the use of voice therapy technique utilized in treatment of muscle tension dysphonia.

An Examination of Surface EMG for the Assessment of Muscle Tension Dysphonia

2013 ◽  
Vol 27 (2) ◽  
pp. 177-186 ◽  
Author(s):  
Evelyne Van Houtte ◽  
Sofie Claeys ◽  
Evelien D’haeseleer ◽  
Floris Wuyts ◽  
Kristiane Van Lierde
Keyword(s):  
Muscle Tension ◽  
Surface Emg ◽  
Muscle Tension Dysphonia

Muscle Tension Dysphonia as a Sign of Underlying Glottal Insufficiency

2002 ◽  
Vol 127 (5) ◽  
pp. 448-451 ◽  
Author(s):  
Peter C. Belafsky ◽  
Gregory N. Postma ◽  
Todd R. Reulbach ◽  
Bradford W. Holland ◽  
James A. Koufman
Keyword(s):  
Vocal Fold ◽  
Muscle Tension ◽  
Voice Disorder ◽  
Vocal Function ◽  
Muscle Tension Dysphonia ◽  
The Face ◽  
Organic Condition ◽  
Glottal Insufficiency ◽  
Organic Voice Disorder ◽  
Male Subjects

BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001). CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.

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