MUSCLE TENSION DYSPHONIA AND SPASMODIC DYSPHONIA - THE ROLE OF MANUALLARYNGEAL TENSION REDUCTION IN DIAGNOSIS AND MANAGEMENT

Excessive activity of the extralaryngeal muscles affects laryngeal fun ction and contributes to a spectrum of interrelated symptoms and syndr omes including muscle tension dysphonia and spasmodic dysphonia. Recog nition of the role of extralaryngeal tension is helpful in ensuring pr oper diagnosis and selection of appropriate treatment. This report dem onstrates the application of manual laryngeal musculoskeletal tension reduction techniques in the diagnosis and management of laryngeal hype rfunction syndromes. The manual technique consists of focal palpation to determine 1) extent of laryngeal elevation, 2) focal tenderness, 3) voice effect of applying downward pressure over the superior border o f the thyroid lamina, and 4) extent of sustained voice improvement fol lowing circum-laryngeal massage. The clinical utility of this innovati ve approach is discussed.