Muscle Tension Dysphonia
Presented by Amanda I. Gillespie
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Muscle tension dysphonia (MTD) is one of the most common voice disorders. It has classically been divided into primary and secondary types. Primary MTD, the focus of this presentation, is best defined as a multifactorial voice disturbance in the absence of structural or neurologic abnormalities. MTD, often a diagnosis of exclusion, is known by many names, which reflects the challenge in identifying one term for a disorder that encompasses a variety of patient-reported symptoms and subjective and objective clinical representations. In this course, Dr. Gillespie will present the historical context of MTD, provide students with an accessible overview of the MTD literature, and discuss current trends in MTD treatment.
Meet your instructor
Amanda I. Gillespie
Dr. Amanda I. Gillespie is an Assistant Professor of Otolaryngology at the Emory University School of Medicine, Director of Speech Pathology, and Co-Director of the Emory Voice Center. She earned an undergraduate degree in speech-language pathology and audiology from New York University and a Master of Science in…
Chapters & learning objectives
1. Historical and Current Perspectives on Muscle Tension Dysphonia
Historically, this class of voice disorder has been known by many names historically, which reflects the challenge of assigning one term to a disorder that presents with a considerable variety of patient-reported symptoms and subjective and objective clinical representations. This chapter will delve into the history of MTD and bring the learner up-to-date on controversies, including preferred terminology.
2. Symptoms of MTD
Patients with MTD report a variety of vocal sound and feel complaints ranging from hoarseness and strain to odynophonia and vocal fatigue. Often the presenting complaints of an individual with MTD are related more to the feel of the voice than to the sound of the voice. This chapter will explore the patient perspective on MTD.
3. Auditory-Perceptual, Acoustic, and Aerodynamic Characteristics of MTD
A range of auditory perceptual, acoustic, and aerodynamic characteristics are associated with MTD. This chapter will discuss the subtypes of MTD and how these relate to objective voice outcomes.
4. Laryngoscopic Findings in MTD
Laryngeal appearance has been used to qualify and categorize types of MTD. These categorizations are not without controversy. Symptoms of MTD with a normal-appearing laryngeal exam have also been reported. The specific muscular tension patterns often observed in MTD and their laryngoscopic correlates will be reviewed in this chapter.
5. Treatment of MTD
The efficacy of direct and indirect voice therapy approaches in treating MTD will be discussed in this chapter. Associated issues of attrition, relapse, and medical and psychological comorbidities that impact treatment will be introduced.
