Muscle Tension Dysphonia

The term “muscle tension dysphonia” (MTD)  is a general term for an inconsistency in the coordination of the muscles and breathing patterns needed to create voice. This inconsistency can be seen without any structural abnormality (primary MTD) or in the presence of a structural abnormality (secondary MTD). If there is a structural issue, the MTD may be the reaction to the abnormality and thus be compensatory in nature. 

Causes of MTD include: stress, anxiety, and viruses (especially upper respiratory). Symptoms include: vocal fatigue; unreliable voice; low, gravelly voice; voice breaks; breathy voice; inability to sing; hoarse and rough quality; lack of projection in voice; vocal symptoms worsen with stress; and voice sometimes returns to normal.  Diagnosis is typically made by an Ear, Nose, and Throat doctor (ENT) and treatment is conducted by a Speech-Language Pathologist.