An accurate diagnosis of Muscle Tension Dysphonia is principally achieved through the recognition of the auditory-perceptual qualities while also eliminating other neurological or structural pathologies with similar auditory-perceptual features (Kunduk, et al., 2016). Knowing the acoustic, endoscopic, and aerodynamic features of MTD facilitates accurate diagnosis (Kunduk, et al., 2016). There are two ways to assess patients for MTD, noninstrumental and instrumental methods. Two noninstrumental methods are case history and palpations. Case history is a routine clinical method to assess muscular tension in potential MTD patients. Patients are asked about a potential history of vocal misuse/abuse and the influences of psychological factors and/or…show more content… Laryngeal manual therapy (LMT) is a term used to describe a method of manual intervention that also incorporates a pre-intervention Palpatory Evaluation Protocol and the Vocal Tract Discomfort Scale (a patient self-rating scale) (Mathieson, 2011). This structured system of manual therapy incorporates kneading the supralaryngeal area, massaging the sternocleidomastoid muscles, and stretching the supralaryngeal muscles through depression of the thyroid cartilage by applying pressure to the superior border of the thyroid cartilage (Mathieson, 2011). Manual circumlaryngeal therapy (MCT) is a term used to refer to the tension reduction method based on Aronson’s technique (Aronson, 1990; Roy, 2008). Circular pressure is applied over the hyoid bone, within the thyrohyoid space and over the posterior borders of the thyroid cartilage; the larynx is then depressed through applying pressure to the superior thyroid border (Mathieson, 2011). It is the systematic kneading of the extralaryngeal region to stretch fascia and muscle tissue, relax tense muscles, promote local circulation with removal of metabolic waste, and relieve pain and discomfort associated with muscle spasms (Aronson, 1990; Roy, 2008). The theorized physical effect of MCT is to reduce laryngeal stiffness and height along with increasing mobility (Roy, 2008). Laryngeal shaking describes a strategy where a…show more content… Though most of the research focusing on the psychosocial factors derives from descriptive studies and depend on reflective commentary from experienced clinicians, some more recent empirical evidence suggests that those early observational studies were accurate and suggest an association between psychosocial factors and the onset of MTD (Baker, 2008). Baker’s literature highlighted how this development could contribute to improving clinical training and clinical practice; if clinicians were more aware of contributing psychosocial factors they could develop more comprehensive treatment plans for
