Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography

Shembel, Adrianna C.; Morrison, Robert A.; Fetzer, David T.; Patterson‐Lachowicz, Amber; McDowell, Sarah E.; Smeltzer, Julianna C. Comstock; Mau, Ted

doi:10.1002/lary.30830

Cited by 7 publications

(1 citation statement)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The exact source of this hyperfunction is not clear. Although it has been commonly assumed that patients with MTD have hyperfunction of the extrinsic laryngeal muscles (ELMs), recent work from our group demonstrated no difference in ELM muscle tension (anterior digastric, geniohyoid, sternohyoid, and thyrohyoid) as measured by ultrasonic shear wave elastography between pMTD patients and controls during quiet breathing 26 . At the same time, however, the MTD patients reported significantly higher levels of vocal effort and vocal tract discomfort 12 .…”

Section: Discussionmentioning

confidence: 50%

Quantification of False Vocal Fold Hyperfunction During Quiet Breathing in Muscle Tension Dysphonia

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background/ObjectivesFalse vocal fold (FVF) hyperfunction during phonation is thought to be a diagnostic sign of primary muscle tension dysphonia (pMTD). However, hyperfunctional patterns with phonation are also observed in typical speakers. This study tested the hypothesis that FVF posturing during quiet breathing, as measured by the curvature of FVF, could differentiate patients with pMTD from typical speakers.MethodsLaryngoscopic images were collected prospectively in 30 subjects with pMTD and 33 typical speakers. Images were acquired at the end of expiration and maximal inspiration during quiet breathing, during sustained /i/, and during loud phonation before and after a 30‐min vocal loading task. The FVF curvature (degree of concavity/convexity) was quantified using a novel curvature index (CI, >0 for hyperfunctional/convex, <0 for “relaxed”/concave) and compared between the two groups.ResultsAt end‐expiration, the pMTD group adopted a convex FVF contour, whereas the control group adopted a concave FVF contour (mean CI 0.123 [SEM 0.046] vs. −0.093 [SEM 0.030], p = 0.0002) before vocal loading. At maximal inspiration, the pMTD group had a neutral/straight FVF contour, whereas the control group had a concave FVF contour (mean CI 0.012 [SEM 0.038] vs. −0.155 [SEM 0.018], p = 0.0002). There were no statistically significant differences in FVF curvature between groups in either the sustained voiced or loud conditions. Vocal loading did not change any of these relationships.ConclusionsA hyperfunctional posture of the FVFs during quiet breathing especially at end‐expiration may be more indicative of a hyperfunctional voice disorder than supraglottic constriction during voicing.Level of Evidence3 Laryngoscope, 2023

show abstract

Section: Discussionmentioning

confidence: 50%

Quantification of False Vocal Fold Hyperfunction During Quiet Breathing in Muscle Tension Dysphonia

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

Optical Flow Analysis of Paralaryngeal Muscle Movement

Morrison,

Fetzer,

Patterson‐Lachowicz

et al. 2023

The Laryngoscope

Self Cite

View full text Add to dashboard Cite

ObjectivesThe paralaryngeal muscles are thought to be hyperfunctional with phonation in patients with primary muscle tension dysphonia (pMTD). However, objective, quantitative tools to assess paralaryngeal movement patterns lack. The objectives of this study were to (1) validate the use of optical flow to characterize paralaryngeal movement patterns with phonation, (2) characterize phonatory optical flow velocities and variability of the paralaryngeal muscles before and after a vocal load challenge, and (3) compare phonatory optical flow measures to standard laryngoscopic, acoustic, and self‐perceptual assessments.MethodsPhonatory movement velocities and variability of the paralaryngeal muscles at vocal onsets and offsets were quantified from ultrasound videos and optical flow methods across 42 subjects with and without a diagnosis of pMTD, before and after a vocal load challenge. Severity of laryngoscopic mediolateral supraglottic compression, acoustic perturbation, and ratings of vocal effort and discomfort were also obtained at both time points.ResultsThere were no significant differences in optical flow measures of the paralaryngeal muscles with phonation between patients with pMTD and controls. Patients with pMTD had significantly more supraglottic compression, higher acoustic perturbations, and higher vocal effort and vocal tract discomfort ratings. Vocal load had a significant effect on vocal effort and discomfort but not on supraglottic compression, acoustics, or optical flow measures of the paralaryngeal muscles.ConclusionOptical flow methods can be used to study paralaryngeal muscle movement velocity and variability patterns during vocal productions, although the role of the paralaryngeal in pMTD diagnostics (e.g., vocal hyperfunction) remains suspect.Level of Evidence2 Laryngoscope, 2023

show abstract

Relationships Between Vocal Fold Adduction Patterns, Vocal Acoustic Quality, and Vocal Effort in Individuals With and Without Hyperfunctional Voice Disorders

Crocker,

Toles,

Morrison

et al. 2024

Journal of Voice

View full text Add to dashboard Cite

Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography

Cited by 7 publications

References 50 publications

Quantification of False Vocal Fold Hyperfunction During Quiet Breathing in Muscle Tension Dysphonia

Quantification of False Vocal Fold Hyperfunction During Quiet Breathing in Muscle Tension Dysphonia

Optical Flow Analysis of Paralaryngeal Muscle Movement

Relationships Between Vocal Fold Adduction Patterns, Vocal Acoustic Quality, and Vocal Effort in Individuals With and Without Hyperfunctional Voice Disorders

Contact Info

Product

Resources

About