The frequency of hard glottal attacks in patients with muscle tension dysphonia, unilateral benign masses and bilateral benign masses

Hard or abrupt glottal attack (HGA) is one of the vocal behaviors often ass ociated with benign lesion of the vocal folds. This study was designed to d etermine whether the frequency of HGA was different in hyperfunctional voic e patients with and without vocal fold masses. One hundred and forty-seven subjects were studied. All subjects received a complete otolaryngological e valuation including strobovideolaryngoscopy, objective voice measures, and evaluation by a speech-language pathologist. Thirty-two patients were diagn osed with muscle tension dyshonia (19 male, 13 female) without vocal fold m asses. Fifty-seven patients were diagnosed with unilateral vocal fold masse s (29 male, 28 female), most of which were cysts. Fifty-eight patients were diagnosed with bilateral vocal fold masses (13 male, 45 female). Of the 45 females with bilateral vocal fold masses, 26 had a vocal cyst and reactive nodule and 19 had bilateral vocal fold nodules. The control group was bala nced and matched based on sex and on percentage of singers and nonsingers. It consisted of 49 subjects with no vocal fold pathology (20 male, 29 femal e). The group was composed of professional speakers, singers, and nonprofes sional speakers. AU voice disordered groups demonstrated higher frequencies of HGA than the control group. Differences were found between the male and female subjects in this study. No differences were found between the vario us disorders. Differences were also found between the subgroups of bilatera l masses, where the bilateral nodules group presented a higher frequency of HGA than the cyst and contralateral reactive nodule.