Muscle Tension Dysphonia, or MTD, is what we call a disturbance in the voice without any pathology present. It is caused by tension you can see and feel in the throat and upper body. There are two types of MTD, the first being the tension being present with no apparent cause. Secondary is compensatory voice behaviors that a patient adopts after a disturbance in the larynx such as a lesion, swelling or paresis. There is excessive tension present as the front and back of the larynx press together. The left and right sides also compress and constrict, resulting in a voice that sounds "odd" and dysphonic. People often report their voice sounds strangled, pressed and pushed. Symptoms can include strain, reduced ability to speak at different pitches and loudness levels, fatigue, and aphonia (no voice). The treatment for MTD is behavioral voice therapy to improve coordination of vocal subsystems. 

Voice therapy teaches you to coordinate your vocal subsystems: breathing, phonation and resonation. You will learn how to reduce tension at the level of the vocal folds and reprogram your muscle memory for speech.