Muscular tension dysphonia (MTD)

This is a syndrome consisting of some or all of the following:
1) excess tension, sometimes to the point of discomfort/ pain in the paralaryngeal and suprahyoid muscles; 2) an open posterior glottic chink during phonation; 3) high larynx position in the neck; 4) inappropriate contraction of pharyngeal constrictors with phonation; and 5) often but not always, vibratory mucosal injury. The term muscular tension dysphonia was coined by Morrison and Rammage at the University of British Columbia.

The vocal cord mucosal changes associated with muscular tension dysphonia are usually fleshy vocal nodules. This syndrome is seen most often in young women.

Photos of muscular tension dysphonia: