Muscle Tension Dysphonia - MTD

In this video we can see the laryngeal inlet appearance upon phonation in muscle tension dysphonia (MTD). This is an imbalance or an excessive activity of extrinsic and/or extrinsic muscles of the larynx. We can see an extreme antero-posterior supraglottic contraction which is typical for the Type III MTD [Morrison-Rammage classification of MTD (1986)].
The voice which is projected, became strained and strangled with tightness which is often felt at upper neck area, surrounding the hyoid cornua areas (palpation may reveals a localized tenderness). The Type II MTD is much more common and usually mangeable by most speech language pathologist/therapist. It is preferred to use the flexible transnasal laryngoscopic examination in an evaluation of any forms of functional dysphonia including MTD.