Dysphonia

Muscle Tension Dysphonia (MTD) is a voice disorder caused by excessive tension in the muscles around the voice box (larynx). This tension can interfere with normal voice production and cause the voice to sound hoarse, tight, strained, or weak. It is not caused by damage to the vocal cords themselves but rather by how the muscles are being used.

MTD can be triggered by a number of factors, including:

• Vocal overuse or misuse (e.g. shouting, singing, excessive talking)
• Stress or anxiety
• Poor posture or breathing technique
• Reflux (acid coming up from the stomach)
• Recovery after a cold or laryngitis
• Underlying voice conditions or compensatory patterns
  

• Hoarse or breathy voice
• Strained or tight voice
• Throat discomfort or a sensation of a lump
• Vocal fatigue – voice tires easily
• Variability in voice quality throughout the day
• Difficulty projecting the voice
  

A diagnosis is usually made by an ENT specialist or a speech and language therapist (SLT) after a detailed history and examination. This may include a laryngoscopy – a test using a small camera to look at your vocal cords while you speak.

The main treatment for MTD is speech and language therapy. This focuses on:

• Reducing muscle tension
• Improving voice technique
• Teaching better breathing and posture
• Managing contributing factors like stress or reflux

You may be referred for therapy after review by an ENT specialist.

• Avoid shouting or whispering
• Rest your voice if it feels tired
• Stay well hydrated
• Practise good posture
• Manage stress through relaxation or breathing techniques
• Avoid throat clearing – sip water or swallow instead
  

• Your voice is hoarse or strained for more than 3 weeks
• You feel discomfort or effort when speaking
• Your voice interferes with your work or social life
• You have a history of voice problems and symptoms are returning
  

Talk to your GP for a referral to an ENT specialist or speech and language therapist. Useful websites:

• NHS: www.nhs.uk
• Voice Care Network UK: www.voicecare.org.uk