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Voice Problems

Hoarseness or voice change is a very common symptom and most of the time has a benign cause. However, in some patients it may be an early sign of voice box or laryngeal cancer, hence patients with persistent hoarseness for more than 4 weeks, especially with a history of smoking, are advised to urgently see their GP or an ENT surgeon for further assessment.

MUSCLE TENSION DYSPHONIA (MTD) 

WHAT IS MUSCLE TENSION DYSPHONIA (MTD)?

Muscle tension dysphonia (MTD) is a condition in which hoarseness or voice change occurs from inappropriate use of the muscles around the larynx or voice box. MTD may happen on its own or it be triggered by a combination of causes such as laryngitis, allergy, reflux, stress, increased vocal demand, vocal cord polyps or nodules.

WHAT ARE THE SYMPTOMS OF MTD?

 

The symptoms of MTD could vary from person to person and may be constant or intermittent. Typical symptoms include:

  • -  Hoarseness

  • -  Vocal weakness and lack of projection.

  • -  Fading of the voice towards the end of sentences or after a period of time.

  • -  Changes in pitch, high or low, or pitch becoming unstable.

  • -  Changes in the quality of the voice whilst talking and/or singing.

HOW IS MTD DIAGNOSED?​

MTD is diagnosed through discussion with your ENT surgeon about your medical history and lifestyle and examination of the voice box and throat with a flexible nasoendoscope (a thin tube with a camera on the end). Examination of the voice box by an ENT Surgeon is important to exclude other structural problems or lumps within the voice box or throat that may be the cause of your voice change.

 

WHAT IS THE TREATMENT FOR MTD?

If there are no lesions noted within the voice box on examination, MTD is usually treated with voice therapy by a speech and language voice therapist (SALT). Therapy may require a few sessions or longer depending on how long the condition has been present, and how well you respond to treatment. Your therapist will find ways for you to exercise your vocal cords more effectively. These may include breathing techniques, advice to stop excessive throat clearing, improving your posture, reducing stress and increasing your vocal hydration. Before referring you for voice therapy, your ENT Consultant may start you on treatment for reflux if require Your voice therapist will advise on how to reduce the effects of MTD and how to prevent symptoms from returning by not causing the voice undue stress through shouting or yelling, not speaking for long periods at a time, not singing or speaking out of your natural range and pitch, and not excessively throat clearing.

Where can I find further information?

Further information can be found at www.britishvoiceassociation.org.uk