Muscle tension dysphonia as a sign of underlying glottal insufficiency

Peter C. Belafsky, Gregory N Postma, Todd R. Reulbach, Bradford W. Holland, James A. Koufman

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001) CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.

Original languageEnglish (US)
Pages (from-to)448-451
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Volume127
Issue number5
DOIs
StatePublished - Nov 1 2002
Externally publishedYes

Fingerprint

Dysphonia
Muscle Tonus
Vocal Cords
Masks
Voice Disorders
Laryngeal Muscles
Laryngoscopy
Paresis
Volunteers
Neck
Head
Confidence Intervals

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Muscle tension dysphonia as a sign of underlying glottal insufficiency. / Belafsky, Peter C.; Postma, Gregory N; Reulbach, Todd R.; Holland, Bradford W.; Koufman, James A.

In: Otolaryngology - Head and Neck Surgery, Vol. 127, No. 5, 01.11.2002, p. 448-451.

Research output: Contribution to journalArticle

Belafsky, Peter C. ; Postma, Gregory N ; Reulbach, Todd R. ; Holland, Bradford W. ; Koufman, James A. / Muscle tension dysphonia as a sign of underlying glottal insufficiency. In: Otolaryngology - Head and Neck Surgery. 2002 ; Vol. 127, No. 5. pp. 448-451.
@article{91058aafc0534096a8f12d7cf1ee9dbb,
title = "Muscle tension dysphonia as a sign of underlying glottal insufficiency",
abstract = "BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60{\%} (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94{\%} (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001) CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95{\%} confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.",
author = "Belafsky, {Peter C.} and Postma, {Gregory N} and Reulbach, {Todd R.} and Holland, {Bradford W.} and Koufman, {James A.}",
year = "2002",
month = "11",
day = "1",
doi = "10.1067/mhn.2002.128894",
language = "English (US)",
volume = "127",
pages = "448--451",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Muscle tension dysphonia as a sign of underlying glottal insufficiency

AU - Belafsky, Peter C.

AU - Postma, Gregory N

AU - Reulbach, Todd R.

AU - Holland, Bradford W.

AU - Koufman, James A.

PY - 2002/11/1

Y1 - 2002/11/1

N2 - BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001) CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.

AB - BACKGROUND: Hyperkinetic vocal function (muscle tension dysphonia) may be an indication of underlying glottal insufficiency. In the face of an organic voice disorder such as presbylaryngis or vocal fold paresis. Hyperkinetic laryngeal behaviors may be used to achieve glottal closure. Such compensatory laryngeal behaviors may mask the correct underlying diagnosis. OBJECTIVE We sought to evaluate the association between vocal fold bowing due to presbylaryngis and abnormal muscle tension patterns (MTPs). METHODS: One hundred consecutive volunteers >40 years old were prospectively evaluated. All underwent a comprehensive head and neck examination that included transnasal fiberoptic laryngoscopy with videostroboscopy. Abnormal MTPs were compared in subjects with and without vocal fold bowing. RESULTS: The mean age of the cohort was 61 years. Eighty-four percent (42 of 50) of the male subjects and 60% (30 of 50) of female subjects had evidence of vocal fold bowing. Of the 72 patients with bowing, 94% (68 of 72) had abnormal MTPs. Compared with subjects without vocal fold bowing, persons with bowing were 17 times more likely to exhibit abnormal MTPs (P < 0.001) CONCLUSIONS: Abnormal MTPs are common in persons with underlying glottal insufficiency. Patients with vocal fold bowing are 17 times more likely to exhibit abnormal MTPs (95% confidence interval, 4.9 to 59.4). Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition.

UR - http://www.scopus.com/inward/record.url?scp=0036832415&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036832415&partnerID=8YFLogxK

U2 - 10.1067/mhn.2002.128894

DO - 10.1067/mhn.2002.128894

M3 - Article

C2 - 12447240

AN - SCOPUS:0036832415

VL - 127

SP - 448

EP - 451

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

SN - 0194-5998

IS - 5

ER -