Muscle tension dysphonia mimicking vocal fold paralysis

Abstract

Muscle tension dysphonia (MTD) is a subtype of functional dysphonias that believed to be the result of misuse or abuse of an anatomically and neurologically intact larynx. MTD is usually seen in young to middle aged population who use his/her voice extensively in stressful situations. We had a 56-year-old female patient who underwent total thyroidectomy surgery and developed bilateral vocal fold paresis after the surgery. She had immediate tracheotomy and followed with tracheotomy tube for years. In our clinic examination, we found hyperadduction of the vocal folds and minimum activity and performed Botox ® (Allergen, Irvine, California, USA) injection to the thyroarytenoid muscles. After 1 week, she decannulated. MTD is a rare and special disease. The disease can be primary without any organic pathology or secondary to a glottic closure problem. First treatment option must be speech therapy, but in resistant cases, surgery or Botox ® (Allergen, Irvine, CA, USA) is suggested.