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Wednesday, August 31, 2011

A Family Doctor's Tale - MUSCLE TENSION DYSPHONIA

DOC I HAVE A MUSCLE TENSION DYSPHONIA

Muscle Tension Dysphonia is an excessive tightness or imbalnce of the muscles in and around the vocal box resulting in hoarseness and difficulty in using the voice.

The causes of Muscle Tension Dysphonia are:
1.Direct problem with the use of vocal technique

2.voice muscle habitual misuse

3.acid reflux from the stomach or laryngopharyngeal reflux

4.underlying inflammation of the vocal cord

5.growth on the vocal cord

6.neurological condition affecting the vocal cord

Symptoms  of Muscle Tension Dysphonia:
1.Hoarse voice

2.strained voice

3.pain or sore throat when talking

4.vocal fatigues easily

5.difficulty controlling pitch

Diagnosis of Muscle Tension Dysphonia:
1.history of voice problem

2.nasoendoscopy through the nose down to vocal cord under local anesthesia to check on the vocal cords

3.videostroboscopy to view the vocal cords ( a thick endocscope with camera is passed down the nose to the vocal cords to examine its movements on video)

4.CT or MRI Scanning of skull from nose to vocal box to look for underlying causes.

5.evaluation of laryngopharyngeal reflux

There can be complications of Muscle Tension Dysphonia such as:
1.chronic hoarseness of voice

2.damage to the vocal cords

Treatment of Muscle Tension Dysphonia:
Medical:
1.Speech therapy
a.to improve voicing techniques
b.overcome bad vocal habits which strain on the voice
c.avoid unneccesary voice use to allow the voice muscles to relax and rest

2.medication to treat acid reflux

Surgery is usually not required.
The prognosis of Muscle Tension Dysphonia is usually fairly good .

Prevention of Muscle Tension Dysphonia:
1.It would be wise to hydrate the throat
2.warm up the voice before talking for long periods of time
3.use a microphone rather than shouting or using a loud voice to convey your message to a large crowd of people
4. Always rest the voice whenever possible

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