This research was supported by a grant from Jennifer Thomas through the Hunter Medical Research Institute.
Involuntary Glottal Closure during Inspiration in Muscle Tension Dysphonia†
Article first published online: 2 JAN 2009
Copyright © 2006 The Triological Society
Volume 116, Issue 4, pages 643–649, April 2006
How to Cite
Vertigan, A. E., Gibson, P. G., Theodoros, D. G., Winkworth, A. L., Borgas, T. and Reid, C. (2006), Involuntary Glottal Closure during Inspiration in Muscle Tension Dysphonia. The Laryngoscope, 116: 643–649. doi: 10.1097/01.MLG.0000201906.41316.FC
Institute where work was performed: John Hunter Hospital, Newcastle, Australia.
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 19 DEC 2005
- Glottal closure;
- muscle tension dysphonia;
- paradoxical vocal fold movement
Objective/Hypothesis: The purpose of this study was to examine respiratory function in a group of patients with muscle tension dysphonia (MTD)
Design: Cross-sectional analytical study.
Methods: Participants included 15 people with a diagnosis of MTD referred to speech pathology for management of their voice disorder, fiberoptic evidence of glottal or supraglottic constriction during phonation with or without posterior chink, or bowing combined and deviation in perceptual voice quality. A second group of 15 participants with no history of voice disorder served as healthy controls. Baseline pulmonary function test measures included forced expiratory volume in the first second (FEV1), FVC, FEF25 to 75, FIF50, FEV1/FVC, ratio and FEF50/FIF50 ratio. Hypertonic saline challenge test measures included FEV1 and FIF50 after provocation, dose response slope, and provocation dose.
Results: Compared with healthy controls, participants with MTD demonstrated a higher prevalence of glottal constriction during inspiration after provocation with nebulized hypertonic saline as demonstrated by a reduction in FIF50 after the hypertonic saline challenge. There was no significant difference between the MTD and healthy control groups in baseline pulmonary function testing. Participants with MTD demonstrated a higher prevalence than healthy controls of abnormal glottic closure during inspiration similar to paradoxical vocal fold movement (PVFM). This suggests that they either had previously undiagnosed coexisting PVFM or that the condition of MTD could be expanded to include descriptions of aberrant glottic function during respiration. This study enhances the understanding of PVFM and MTD by combining research advances made in the fields of otolaryngology and respiratory medicine.