Combined Functional Voice Therapy in Singers With Muscle Tension Dysphonia in Singing

J Voice. 2017 Jul;31(4):509.e23-509.e31. doi: 10.1016/j.jvoice.2016.10.026. Epub 2016 Dec 15.


Objectives: The purpose of this study was to evaluate vocal tract function and the voice quality in singers with muscle tension dysphonia (MTD) after undergoing combined functional voice therapy of the singing voice.

Design: This is a prospective, randomized study.

Methods: Forty singers (29 females and 11 males, mean age: 24.6 ± 8.8 years) with MTD were enrolled in the study. The study group consisted of 20 singers who underwent combined functional voice therapy (10-15 individual sessions, 30-40 minutes each). Singers who did not opt for vocal rehabilitation consisted of the control group. Effects of rehabilitation were assessed with videolaryngostroboscopy, palpation of the vocal tract structures, flexible fiberoptic evaluation of the pharynx and the larynx, perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, and the Voice Handicap Index.

Results: After combined functional voice therapy in the study group, great improvement was noticed in palpation of the vocal tract structures (P < 0.001), perceptual voice assessment (P < 0.001), phonetograms (P = 0.002), and singing range obtained from acoustic analysis of glissando (P < 0.001). In the control group, no statistically significant differences were found between the first and the second assessments.

Conclusions: Combined functional voice therapy proved to be an efficacious treatment method in singers with MTD in singing. Development of palpation and perceptual singing voice examination protocols enables one to compare results before and after rehabilitation in clinics.

Keywords: Combined functional voice rehabilitation; Muscle tension dysphonia; Palpation of the vocal tract structures; Perceptual singing voice assessment; Singing voice disorders.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Dysphonia / physiopathology
  • Dysphonia / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Tonus
  • Palpation
  • Prospective Studies
  • Singing*
  • Voice Quality*
  • Voice Training*
  • Young Adult