Description and Etiology

Muscle tension dysphonia is the presents of increased muscle activity in the head and neck.  People often describe feelings of stress, anxiety, depression, high vocal demand, issues with time management, and general complaints of being overloaded both physically and emotionally.  Laryngopharyngeal reflux (LPR) might also be associated with MTD.

Perceptual Signs and Symptoms

  • Voice quality:
    • Strained
    • High pitch
  • When vocal fold tension appears high:
    • Folds may never close
    • Breathy and weak sound quality

Features of Visual Assessment

  • Excessive contraction of laryngeal muscles and surrounding tissues
  • Neck and shoulders often look tense
  • Decreased vibratory characteristics of the vocal folds
  • Glottic gaps:
    • Can present with incomplete closure


  • Voice therapy:
    • Biofeedback
    • Laryngeal relaxation techniques
    •  Resonant voice therapy
    • Laryngeal massage