Muscle Tension Dysphonia

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Muscle Tension Dysphonia

Muscle tension dysphonia (MTD) is a voice disorder characterized by the changes in the voice as a result of extreme muscle tension in the larynx (voice box). It develops when muscles around the voice box tighten while speaking or singing. It affects more women than men, and you are at a higher risk if your age is between 50 to 60 years.

There are two types of MTD, primary and secondary MTD. With primary MTD, muscles in your voice box tighten, making it difficult to talk. However, there is no abnormality in the voice box. With secondary MTD, your voice box has an abnormality which causes increased use of muscles to compensate for the adverse effects of an underlying problem.

What’s the cause of MTD? The exact cause of muscle tension dysphonia is unknown. However, it can be triggered by the following factors:

  • Increased demand for voice
  • Smoking
  • Allergies
  • Reflux
  • Irritants, such as upper respiratory infections

In some cases, anxiety and emotion-related disorders are suspected of causing MTD.

What are the symptoms of MTD?

MTD may result in a wide array of symptoms. Some of the signs to watch out include:

  • A voice that is hoarse, raspy, or rough
  • A voice that sounds weak or breathy, especially at the end of the sentence
  • Intermittent sound breaks
  • Pain or discomfort in the throat when singing or talking
  • Too low or too high pitch
  • Challenges while singing notes that were once simple
  • A sense of tiredness in the throat when speaking or singing
  • A feeling of tenderness or lump in the throat

To note is that the above symptoms vary with the demand for voice. They also differ from person to person. They can also develop intermittently. At times your voice is normal, and then hoarseness crops up without any warning sign.

Are you experiencing any of the above symptoms? Please visit Westside Head & Neck for a comprehensive MTD exam. Our ENT doctor in Los Angeles will carry out a complete checkup to determine the precise cause of your symptoms.

Diagnosis of MTD

MTD can be diagnosed by a voice specialist or a speech-language pathologist (SLT). How do they diagnose? There is no definite diagnostic tool for MTD. However, voice specialists carry out the following procedures to be as accurate as possible.

  • Take a historical background of your voice problems
  • Evaluate how you speak
  • Examine your larynx

To examine your larynx further, your SLT may use his hands to feel if there is tenderness or lumps in your throat. Also, thorough a procedure called laryngoscopy; your doctor can have a better view of your voice box. Many conditions could mimic MTD. To be sure, visit a specialist for proper diagnosis to determine what’s troubling your throat.

Muscle tension dysphonia treatment

There are a couple of treatment options available for MTD. Let’s dive into them.

  • Voice therapy

It is the most common type of treatment. Your doctor examines how you use your voice. After observation, your doctor uses the below methods to facilitate you to use your voice effectively. These methods are:

  • Working on your posture
  • Working on your breathing sequence to improve your voice
  • Throat massage to reduce the tension of your voice box muscles
  • Vocal exercises to distribute load while talking or singing
  • Throat relaxation techniques to reduce tightening of your larynx muscles

The above techniques are dependent on whether your MTD is primary or secondary. Your doctor will use a combination of the above methods that are specific to your case.

In your voice therapy journey, the SLT will also advise you against triggers that may be contributing to MTD. He could recommend the following to alleviate your problem:

  • Medication in case of upper respiratory infections and reflux
  • Identify and advise to stop substances triggering allergy in your throat
  • Avoid smoking

To undertake voice therapy, you need a specialist with long-standing experience in the field. Contact our team of board-certified doctors at Westside Head & Neck. Our experts shall provide comprehensive guidance that will get you back to your healthy self.

  • Vocal cord surgery

It’s opted to address underlying issues that have damaged your voice box muscles. Surgery is usually recommended as the last option. Vocal cord surgery aims to remove lumps, polyps, and other tumors that are inhibiting your voice box from functioning optimally.

How is vocal cord surgery done? It can be done by making a surgical incision on your neck. It can also be done by inserting a tube through your mouth. In both instances, you will be under general anesthesia.

Tracheostomy may be necessary, to improve your ability to breathe and swallow, if your throat pathway narrows after surgery.

Are there any risks of larynx surgery? Like any other surgery, larynx surgery comes with risks, such as infection, bleeding, and adverse reaction to anesthesia. Other risks include damage to the voice box and breathing difficulties. The rapture of the carotid artery is rare, but it can occur.

Vocal cord surgery Los Angeles

If you have been diagnosed with MTD and surgery is the way out, visit Westside Head & Neck for vocal cord treatment. Also, to aid your recovery process, consult us for tracheostomy treatment in Los Angeles.

We are dedicated to providing the best treatment using the latest technology for optimal results.

Can I prevent MTD?

If you are in the risky age bracket, observing the following will go a long way in the prevention of MTD. Try to avoid:

  • Screaming and yelling
  • Raising your voice, especially against noise
  • Coughing excessively
  • Speaking/singing loudly when out of breath
  • A high pitch that you are uncomfortable with
  • Stretching your throat muscles when singing

Even though there is no known cause of MTD, observing good voice care is pivotal in reducing the chances. Again, schedule a visit with a voice specialist immediately when you notice a change in your voice.

Head and neck doctors Los Angeles

Is MTD troubling you? We offer comprehensive healthcare from consultation to treatment. Visit us today for proper diagnosis for treatment and rehabilitation services like voice and speech therapy. Patients experiencing breathing problems due to tracheal stenosis should act immediately.

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Our Services

Voice & Swallowing Disorders

Muscle Tension DysphoniaPhilosophy
At Westside Head and Neck, we will provide you with expert, state-of-the art care for voice, swallowing, and airway disorders. We believe in a multidisciplinary approach involving medical treatment, minimally-invasive surgery when necessary, and voice therapy.

We offer specialized diagnostic tools and therapy for people with voice problems caused by benign growths or lesions (nodules, polyps, cysts, papillomas, granulomas, vascular lesions, scar or sulcus), chronic or acute laryngitis, the aging voice, spasmodic dysphonia, vocal cord paralysis, muscle tension dysphonia, laryngopharyngeal reflux, cancer of the larynx, and neurologic conditions affecting the larynx. We care for professional voice users, including singers, actors, teachers, and attorneys. For patients with breathing or swallowing problems, we provide diagnostic and therapeutic strategies.

Patient Care
Patients receive a comprehensive evaluation of vocal function including analysis of speech and voice quality and videostroboscopic examination of the larynx. Laryngeal Videostroboscopy is a routine, non-painful component of this evaluation and allows the physician to assess the laryngeal anatomy, pliability of the vocal folds, and motion of the vocal cords. This can be done using a rigid or flexible endoscope, and topical anesthetic is routinely used. After the evaluation, a management and treatment plan is developed with the patient. This may include in-office procedures, medication, voice therapy, or surgery.

Common Voice and Larynx Conditions

  • Chronic sore throat
  • Cough
  • Hoarseness
  • Laryngopharyngeal Reflux Disease (LPR) & GERD
  • Laryngitis
  • Reactive vocal cord lesion
  • Spasmodic dysphonia
  • Swallowing disorders
  • Vocal cord cysts/nodules/polyps
  • Vocal cord paralysis


  • Voice rest
  • Speech / Voice therapy & practices
  • Reflux medicines & lifestyle modifications
  • Vocal cord nodule, polyp and cysts removal
  • Vocal cord medialization
  • Tracheotomy
  • Voice prosthesis
  • Antibiotics
  • Flexible fiberoptic laryngoscopy
  • Vocal cord injections

I am so grateful that I found Dr. Salvado. I’m a voice over actor who sings at church on the weekends so when my voice started to go on the fritz I was absolutely panicked. Dr. Salvado took one easy look (no tube up the nose and down the throat!! My first time not being scoped for vocal issues!!) and quickly saw what the problem was. Following her plan for rehabilitation for me, my voice is back to fully functioning and even clearer than before I started having issues. I’m so happy I found Dr. Salvado, laryngologists are hard to come by and she’s excellent. I highly recommend her!show lessAnastasia C. · February 4, 2020 via Zocdoc

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