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Muscle Tension Dysphonia

presented by Amanda I. Gillespie, PhD, CCC-SLP

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Financial: Amanda I. Gillespie receives compensation from MedBridge for this course. She is the co-investigator on R03 DC015305-01, an NIH grant on conversation training therapy. Non-Financial: Amanda I. Gillespie has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 48 Minutes, Learning Assessments: 19 Minutes

Muscle tension dysphonia (MTD) is one of the most common voice disorders. It has classically been divided into primary and secondary types. Primary MTD, the focus of this presentation, is best defined as a multifactorial voice disturbance in the absence of structural or neurologic abnormalities. MTD, often a diagnosis of exclusion, is known by many names, which reflects the challenge in identifying one term for a disorder that encompasses a variety of patient-reported symptoms and subjective and objective clinical representations. In this course, Dr. Gillespie will present the historical context of MTD, provide students with an accessible overview of the MTD literature, and discuss current trends in MTD treatment.

Meet Your Instructor

Amanda I. Gillespie, PhD, CCC-SLP

Dr. Amanda I. Gillespie is an Assistant Professor of Otolaryngology at the Emory University School of Medicine, Director of Speech Pathology, and Co-Director of the Emory Voice Center. She earned an undergraduate degree in speech-language pathology and audiology from New York University and a Master of Science in speech-language pathology from the University of Pittsburgh.…

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Chapters & Learning Objectives

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1. Historical and Current Perspectives on Muscle Tension Dysphonia

Historically, this class of voice disorder has been known by many names historically, which reflects the challenge of assigning one term to a disorder that presents with a considerable variety of patient-reported symptoms and subjective and objective clinical representations. This chapter will delve into the history of MTD and bring the learner up-to-date on controversies, including preferred terminology.

2. Symptoms of MTD

Patients with MTD report a variety of vocal sound and feel complaints ranging from hoarseness and strain to odynophonia and vocal fatigue. Often the presenting complaints of an individual with MTD are related more to the feel of the voice than to the sound of the voice. This chapter will explore the patient perspective on MTD.

3. Auditory-Perceptual, Acoustic, and Aerodynamic Characteristics of MTD

A range of auditory perceptual, acoustic, and aerodynamic characteristics are associated with MTD. This chapter will discuss the subtypes of MTD and how these relate to objective voice outcomes.

4. Laryngoscopic Findings in MTD

Laryngeal appearance has been used to qualify and categorize types of MTD. These categorizations are not without controversy. Symptoms of MTD with a normal-appearing laryngeal exam have also been reported. The specific muscular tension patterns often observed in MTD and their laryngoscopic correlates will be reviewed in this chapter.

5. Treatment of MTD

The efficacy of direct and indirect voice therapy approaches in treating MTD will be discussed in this chapter. Associated issues of attrition, relapse, and medical and psychological comorbidities that impact treatment will be introduced.

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