Vocal fold abnormalities in laryngeal tension-fatigue syndrome.

This study sought to use videostrobolaryngoscopy to clarify possible biomechanical causes of dysphonia in patients with laryngeal tension-fatigue syndrome, a chronic functional dysphonia due to vocal abuse and misuse. The videostrobolaryngoscopic records of 301 laryngeal tension-fatigue syndrome patients were reviewed. The focus of observation was the visual characteristics of the mucus layer, vessel dilatation or neovascularization on the surface of vocal folds, abnormal glottal closure, and bilateral vibratory asymmetry. Abnormal findings on the vocal folds, especially during vibration, were noted in 270 cases (89.7%). Most patients (222, 73.8%) had multiple abnormalities. The results of this study suggest that chronic vocal overuse under excessive laryngeal muscle tension can cause phonotrauma and result in biomechanical property changes in the vocal fold's cover. These changes would hinder the regular vibration of the vocal folds, increase irregularities in voice signals, and worsen the symptoms of dysphonia.