Involuntary glottal closure during inspiration in muscle tension dysphonia.
OBJECTIVE
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.
Division of Speech Pathology, University of Queensland, Brisbane, Queensland, Australia. anne.vertigan@hnehealth.nsw.gov.au
Anne E
AE
Vertigan
Peter G
PG
Gibson
Deborah G
DG
Theodoros
Alison L
AL
Winkworth
Trevor
T
Borgas
Colin
C
Reid
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D005931:Glottis / Q000503:physiopathology*; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D007821:Laryngeal Muscles / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D012720:Severity of Illness Index; D014827:Vocal Cords / Q000503:physiopathology; D014832:Voice Disorders / Q000503:physiopathology*; D014833:Voice Quality