Comparison Between Palpatory Findings of the Hyoid Position and Their Acoustic, Videostroboscopic, and Perceptual Attributes in Patients With Muscle Tension Dysphonia (With and Without Organic Lesions)

Abstract

The direction in which the hyoid is pulled may change as a result of muscle tension dysphonia (MTD). The disposition usually occurs owing to paralaryngeal muscular imbalance (decompensation), which can create laryngeal dysfunction and consequently deteriorating the voice quality. This study aimed at reporting on a comparison between palpatory findings of hyoid position and their acoustic and perceptual and stroboscopic attributes among patients with MTD. Cross-sectional random triple-blinded study. Palpatory, acoustic, audioperceptual, and stroboscopic findings of 39 patients with MTD were analyzed descriptively and using independent sample t test. Dominant perceptual vocal characteristic of patients with pulled-up hyoid position was rough and the degrees of jitter and shimmer were higher in patients with pulled-up hyoid position than in patients with pulled-down hyoid position (jitter, P=0.019; shimmer, P=0.004), whereas signal-to-noise (S/N) ratio was lower in patients with pulled-up hyoid position than in pulled-down hyoid patients, but not significantly (S/N ratio, P=0.56). The dominant perceptual characteristic of patients with pulled-up hyoid position was rough voice, whereas that for pulled-down hyoid patients was strained voice. On the other hand, the dominant observable pattern in patients with pulled-up hyoid was MTD type II (lateral constriction), whereas that in patients with pulled-down hyoid was MTD type III (moderate anteroposterior constriction). There is a general congruence between the hyoid pulled direction and its perceptual, acoustic, and videostroboscopic findings in patients with MTD.