Anatomic correlation for muscle tension dysphonia.

Dysphonia resulting from increased muscular tension in the larynx and neck is associated with 1) palpably increased phonatory muscle tension in the paralaryngeal and suprahyoid muscles, 2) elevation of the larynx in the neck on increasing vocal pitch, 3) an open posterior glottic chink between the arytenoid cartilages on phonation, and 4) variable degrees of mucosal changes such as vocal nodules or chronic laryngitis. Using six cadaver larynges, the glottic features observed during examination of patients with muscular tension dysphonia (MTD) are reproduced. In each larynx the posterior, lateral, and interarytenoid muscles were dissected free and tension applied in the direction of action in various combinations. Glottic changes were observed, recorded on videotape, and compared to similar clinical video recordings.