Muscle Tension Dysphonia (MTD)
Muscle tension is the overuse of neck and throat muscles when speaking or singing, Tension is often the result of trying to compensate for irritation, weakness, swelling or a growth that is causing the imbalance.
Although vocal fold nodules (or singer’s nodes) are frequently diagnosed, nodules are far less common than other benign vocal growths which include cysts and polyps. Symptoms include hoarseness, breathiness, loss of singing range and voice breaks.
Vocal Fold Paralysis
Failure of one vocal fold to move during speaking may be due to a stroke, trauma to a nerve during surgery or a result of a viral disease. The primary vocal problem is breathiness.
Also described as “stuttering of the larynx,” the voice sounds strained and strangled., rapidly starting and stopping. The voice sounds choppy. Hoarse and tight. Thought to be a movement disorder, or dystonia, it is treated with Botox injections and voice therapy.
Vocal fold incompetence, or bowing, is a condition when the vocal folds do not completely come together during speaking. The condition can be due to poor muscle strength or loss of tone, often associated with aging or neurological conditions such as Parkinson’s disease. Breathiness, hoarseness and fatigue are the primary complaints.
Paradoxical Vocal Fold Movement (PVFM) or Vocal Cord Dysfunction (VCD)
This abnormal vocal fold movement often occurs during physical exercise, resulting in shortness of breath, tightening of the muscles in the throat and wheezing. It is often misdiagnosed as an asthmatic attack.
Laryngopharyngeal Reflux (LPR)
Caused by the regurgitation of stomach contents up through the esophagus into the throat, stomach acid coats and damages the tissues of the throat. People often complain of voice changes, throat clearing, mucus in the throat, trouble swallowing, a globus or lump in the throat, burning in the throat or chronic sore throats. Most of the people do not have heartburn or indigestion, typical of GERD (Gastroesophageal Reflux Disease). Patients with LPR are often unaware of their condition.\
Although chronic cough has been associated with asthma, sinusitis or allergy, it is often related to LPR or a vagal neuropathy. LPR is reflux that irritates the back of the throat. A vagal neuropathy can cause a cough that is usually preceded by a tickle sensation, made worse by talking, eating, cold air or laughing and often occurs in spasms. Depending on the cause, the symptoms can be treated by different medications.
Hoarseness is the primary sign and symptom. There may be pain when swallowing or tenderness in the neck. Early diagnosis often results in an excellent prognosis.