Laryngeal massage may be an effective treatment for primary muscle tension dysphonia (MTD). MTD occurs when there is excess musculoskeletal tension in the larynx, either as a primary cause or secondary cause of voice problems. Indirect tension reduction techniques often fail to reduce stubborn laryngeal tension. Laryngeal massage aims to manually assess and reduce contracted muscle tone and abnormal laryngeal positioning during voicing through a series of cautious steps with the active participation of the patient to improve vocal quality in daily use. Raising awareness of bodily sensations may help prevent future muscle tension.

1. The Use of Laryngeal Massage in Treating Primary Muscle Tension Dysphonia (“MTD”)Felicity GrahamVoice Disorders – BBSQ 5113March 7, 20111

2. Introduction: What is MTD?2

3. What is MTD? Cont’d3

4. Rationale: Tension & MTDAll patients with voice disorders, regardless of etiology, should be tested for excess musculoskeletal tension, either as a primary or as a secondary cause of the dysphonia.(Aronson, 1990)Effective Therapy?…indirect (i.e., non-manual) tension reduction techniques often fail because of the stubborn nature of excess laryngeal musculoskeletal tension (Roy, 2008).Circular Nature of Tension on Phonation4

5. Treatment: Principles5

6. Treatment: Manual TherapyWhy is vocalization so important?“In some cases of muscle misuse, the larynx abnormally contracts during voicing, but returns to normal during rest.The clinician is encouraged to manually assess not only resting muscle tone, but also contracted muscle tone and laryngeal position observed during voicing attempts (Roy, 2008).”6

7. Treatment: Steps7According to Roy (2008), the patient should be considered an active participant, and encouraged to become aware of and monitor the changes in vocal quality during treatment, in order to transfer their progress into daily conversation.(Sources: Roy, 2008; Van Lierde, et al., 2010; Mathieson, et al., 2009; Aronson, 1990)

8. Treatment: Cautions8

9. …perhaps the most important step in preventing muscle tension is becoming conscious of the sensory […] experience (Deeter, 2005).9Summary

10. (See handout for notes and bibliography)10