Muscle tension dysphonia: concept and diagnostic criteria

Disfonía por tensión muscular: concepto y criterios diagnósticos

Introduction. Muscle tension dysphonia has been defined since 1983 as a disorder in which there is an imbalance in laryngeal muscle tension forces, without evidence of structural or neurological pathology; it has also been called type I muscle tension dysphonia. The characteristics that in practice have been considered part of the diagnosis are not standardized.

Objective. To review current information, not older than 5 years, on muscle tension dysphonia, unifying current diagnostic criteria.

Methodology. A systematic search was carried out through the Pub Med, Google Scholar, and Cochrane databases. The MESH terms used were: muscle tension dysphonia, functional dysphonia, hyperkinetic dysphonia, and vocal fatigue. Inclusion criteria: articles published in peer-reviewed journals, regardless of design and published no more than 5 years before. Exclusion criteria: articles whose main focus was not muscle tension dysphonia and with a language other than English or Spanish.

Results. Two studies report more pathology in women than men; four investigations report increased subglottic pressure (> 90 mmHg); three studies reported phonatory measures; a work proposes high-resolution video as a demonstration of vocal hyperfunction; an investigation evaluated mucosal wave by electroglottography; an investigation studied the use of functional magnetic resonance imaging; another work proposed a pilot study of infrahyoid muscle blood flow assessment: another work reviews the use of diagnostic methods.

Conclusions. The parameters of greater weight were cepstral peak and subglottic pressure. It is still necessary to expand the knowledge with new research that allows universal criteria.