title: The evidence for laryngeal manual therapies in the treatment of muscle tension dysphonia.
abstract: OBJECTIVE
  Clinicians involved in treating patients with voice disorders are showing an increasing interest in manual therapies aimed at reducing excessive tension in the perilaryngeal area. Studies investigating the effects of this treatment have been appearing in the literature since the early 1990s, but the evidence base remains extremely small. The purpose of this review is to provide the reader with current information about the types of laryngeal manual therapy in clinical use internationally and the evidence base for their use.
  
  
  RESULTS
  The results of studies undertaken recently reinforce the results of earlier studies, most of which have been conducted using individuals with muscle tension dysphonia. The various types of laryngeal manual therapy have all been shown to have positive effects.
  
  
  CONCLUSIONS
  There is evidence that laryngeal manual therapy, in various forms, can be a useful primary intervention in cases of muscle tension dysphonia, although this is based on very few studies. A higher level of evidence is required, including randomized controlled trials, to investigate its role in comparison with other interventions. Studies are also needed to verify or refute the clinical observation that it is also an effective treatment for all voice disorders, including those of organic aetiology, when phonatory hyperfunction is a feature.
authors.affiliation: The Ear Institute, University College London, and Speech and Language Therapy Department, Royal National Throat Nose and Ear Hospital, London, UK. lesley_mathieson@yahoo.com
authors.forename: Lesley
authors.initials: L
authors.lastname: Mathieson
mesh_terms: D055154:Dysphonia / Q000534:rehabilitation*; D006801:Humans; D007821:Laryngeal Muscles; D008405:Massage / Q000379:methods*; D009126:Muscle Relaxation