From the Guidelines
The treatment for prebylaryngeal muscle tension dysphonia primarily involves voice therapy with a speech-language pathologist, focusing on techniques to reduce excessive tension in the muscles around the larynx, as recommended by the most recent consensus guidelines 1. The goal of this therapy is to educate the patient about the nature of the disorder and to provide strategies for managing symptoms.
Key Components of Therapy
- Education and explanatory approaches to help the patient understand the disorder and its management
- Symptomatic strategies, including:
- Natural, reflexive, or instinctive behaviors accompanied by sound, such as coughing, yawning, or whimpering
- Vocal exercises, like gargling, phonation on inhalation, or producing low-pitched glottal fry
- Physical and postural maneuvers, including reposturing, repositioning, or lowering of the larynx, and circumlaryngeal massage with concurrent vocalization 1
- Psychological support to address any underlying issues that may be contributing to the disorder, such as anxiety or depression
Importance of Patient Engagement
Patient engagement and practice are crucial for the success of therapy, with regular practice of prescribed exercises expected to lead to improvement within 4-6 weeks.
Additional Considerations
While the primary approach is voice therapy, in some cases, additional interventions like biofeedback, breathing exercises, or stress reduction techniques may be beneficial. It is essential to note that the treatment should be tailored to the individual patient's needs and may involve a combination of these approaches. As stated in the consensus guidelines, outcomes are more likely to be positive if the patient understands the relationship between the voice problem and any ongoing psychosocial issues and has strategies in place to deal with them 1.
From the Research
Treatment Options for Prebylaryngeal Muscle Tension Dysphonia
- The treatment for prebylaryngeal muscle tension dysphonia typically involves a multidisciplinary approach, including voice therapy, vocal hygiene, and patient education 2.
- Voice therapy is considered an effective treatment option, with techniques such as indirect therapy, direct therapy, and circumlaryngeal manual therapy (CMT) showing promise in improving voice outcomes 3, 2.
- Vocal hygiene and patient education are also important components of treatment, as they can help patients develop healthy vocal habits and reduce tension in the laryngeal muscles 2, 4.
Specific Treatment Techniques
- Voice therapy may involve techniques such as awareness, relaxation, respiration, and easy-onset phonation to reduce tension around the laryngeal muscles 5.
- CMT may also be used to help relieve hyper-contraction of the supraglottic structures and improve voice quality 2.
- Referral to speech pathology and stroboscopy may also be recommended for patients with muscle tension dysphonia 6.
Importance of Multidisciplinary Approach
- A multidisciplinary approach, involving close cooperation between a laryngologist and a speech-language pathologist, is considered essential for effective treatment of prebylaryngeal muscle tension dysphonia 2.
- This approach can help ensure that patients receive comprehensive care and that treatment is tailored to their individual needs.