Muscular tension dysphonia.

Muscular tension dysphonia (MTD) is a condition commonly seen in young and middle aged females. It is manifest by excess tension in the paralaryngeal and suprahyoid muscles, an open posterior glottic chink, larynx rise, and frequently mucosal changes on the vocal cords. These mucosal changes are usually fleshy vocal nodules. About 8% of vocal nodules are found in patients not exhibiting features of MTD. The two types of vocal nodules require different therapeutic approaches. One hundred patients out of 500 seen consecutively at the Voice Clinic at the University of British Columbia exhibited the features of MTD. These patients are discussed and an etiology hypothesis is presented.