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Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge

EVELYNE VAN HOUTTE UGent, Kristiane Van Lierde UGent and Sofie Claeys UGent (2011) JOURNAL OF VOICE. 25(2). p.202-207
abstract
Objective. Muscle tension dysphonia (MTD) is a clinical and diagnostic term describing a spectrum of disturbed vocal fold behavior caused by increased tension of the (para)laryngeal musculature. Recent knowledge introduced MTD as a bridge between functional and organic disorders. This review addresses the causal and contributing factors of MTD and evaluates the different treatment options. Methods. We searched MEDLINE (Pubmed, 1950-2009) and CENTRAL (The Cochrane Library, Issue 2,2009). Studies were included if they reviewed the classification of functional dysphonia or the pathophysiology of MTD. Etiology and pathophysiology of MTD and circumlaryngeal manual therapy (CMT) were obligatory based on reviews and prospective cohort studies because randomized controlled trials (RCTs) are nonexisting. Concerning the treatment options of voice therapy and vocal hygiene, selection was based on RCTs and systematic reviews. Results. Etiological factors can be categorized into three new subgroups: (1) psychological and/or personality factors, (2) vocal misuse and abuse, and (3) compensation for underlying disease. The effective treatment options for MTD are (1) indirect therapy: vocal hygiene and patient education; (2) direct therapy: voice therapy and CMT; (3) medical treatment; and (4) surgery for secondary organic lesions. Conclusions. MTD is the pathological condition in which an excessive tension of the (para)laryngeal musculature, caused by a diverse number of etiological factors, leads to a disturbed voice. Etiological factors range from psychological/personality disorders and vocal misuse/abuse to compensatory vocal habits in case of laryngopharyngeal reflux, upper airway infections, and organic lesions. MTD needs to be approached in a multidisciplinary setting where close cooperation between a laryngologist and a speech language pathologist is possible.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
Functional dysphonia, Functional voice disorder, Muscle tension dysphonia, Muscle misuse voice disorders, Circumlaryngeal manual therapy, Videostroboscopy, FUNCTIONAL VOICE DISORDERS, TREATMENT OUTCOMES, SURFACE EMG, THERAPY, LARYNGEAL, PERSONALITY, CLASSIFICATION, REDUCTION, DIAGNOSIS, REFLUX
journal title
JOURNAL OF VOICE
J. Voice
volume
25
issue
2
pages
202 - 207
Web of Science type
Review
Web of Science id
000288143900010
JCR category
OTORHINOLARYNGOLOGY
JCR impact factor
1.39 (2011)
JCR rank
15/41 (2011)
JCR quartile
2 (2011)
ISSN
0892-1997
DOI
10.1016/j.jvoice.2009.10.009
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
851833
handle
http://hdl.handle.net/1854/LU-851833
date created
2010-02-04 15:17:59
date last changed
2011-07-14 11:31:08
@article{851833,
  abstract     = {Objective. Muscle tension dysphonia (MTD) is a clinical and diagnostic term describing a spectrum of disturbed vocal fold behavior caused by increased tension of the (para)laryngeal musculature. Recent knowledge introduced MTD as a bridge between functional and organic disorders. This review addresses the causal and contributing factors of MTD and evaluates the different treatment options.
Methods. We searched MEDLINE (Pubmed, 1950-2009) and CENTRAL (The Cochrane Library, Issue 2,2009). Studies were included if they reviewed the classification of functional dysphonia or the pathophysiology of MTD. Etiology and pathophysiology of MTD and circumlaryngeal manual therapy (CMT) were obligatory based on reviews and prospective cohort studies because randomized controlled trials (RCTs) are nonexisting. Concerning the treatment options of voice therapy and vocal hygiene, selection was based on RCTs and systematic reviews.
Results. Etiological factors can be categorized into three new subgroups: (1) psychological and/or personality factors, (2) vocal misuse and abuse, and (3) compensation for underlying disease. The effective treatment options for MTD are (1) indirect therapy: vocal hygiene and patient education; (2) direct therapy: voice therapy and CMT; (3) medical treatment; and (4) surgery for secondary organic lesions.
Conclusions. MTD is the pathological condition in which an excessive tension of the (para)laryngeal musculature, caused by a diverse number of etiological factors, leads to a disturbed voice. Etiological factors range from psychological/personality disorders and vocal misuse/abuse to compensatory vocal habits in case of laryngopharyngeal reflux, upper airway infections, and organic lesions. MTD needs to be approached in a multidisciplinary setting where close cooperation between a laryngologist and a speech language pathologist is possible.},
  author       = {VAN HOUTTE, EVELYNE and Van Lierde, Kristiane and Claeys, Sofie},
  issn         = {0892-1997},
  journal      = {JOURNAL OF VOICE},
  keyword      = {Functional dysphonia,Functional voice disorder,Muscle tension dysphonia,Muscle misuse voice disorders,Circumlaryngeal manual therapy,Videostroboscopy,FUNCTIONAL VOICE DISORDERS,TREATMENT OUTCOMES,SURFACE EMG,THERAPY,LARYNGEAL,PERSONALITY,CLASSIFICATION,REDUCTION,DIAGNOSIS,REFLUX},
  language     = {eng},
  number       = {2},
  pages        = {202--207},
  title        = {Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge},
  url          = {http://dx.doi.org/10.1016/j.jvoice.2009.10.009},
  volume       = {25},
  year         = {2011},
}

Chicago
VAN HOUTTE, EVELYNE, Kristiane Van Lierde, and Sofie Claeys. 2011. “Pathophysiology and Treatment of Muscle Tension Dysphonia: a Review of the Current Knowledge.” Journal of Voice 25 (2): 202–207.
APA
VAN HOUTTE, E., Van Lierde, K., & Claeys, S. (2011). Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. JOURNAL OF VOICE, 25(2), 202–207.
Vancouver
1.
VAN HOUTTE E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. JOURNAL OF VOICE. 2011;25(2):202–7.
MLA
VAN HOUTTE, EVELYNE, Kristiane Van Lierde, and Sofie Claeys. “Pathophysiology and Treatment of Muscle Tension Dysphonia: a Review of the Current Knowledge.” JOURNAL OF VOICE 25.2 (2011): 202–207. Print.