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Acta Otorrinolaringol Esp. 2012 May-Jun;63(3):200-5. doi: 10.1016/j.otorri.2011.12.003. Epub 2012 Mar 19.

[The use of fibrolaryngoscopy in muscle tension dysphonia in telemarketers].

[Article in Spanish]

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Servicio de Otorrinolaringología, Sanatorio Allende, Córdoba Capital, Provincia de Córdoba, Argentina.



Muscle tension dysphonia (MTD) is a voice disorder in the absence of current organic laryngeal pathology, without obvious psychogenic or neurological aetiology. The laryngeal features of MTD include a posterior glottal gap and supraglottic hyperfunctional activities; however, it remains unclear if these features are specific to MTD. This report aims to compare the laryngeal features in telemarketer patients with MTD versus non-dysphonic control subjects.


We reported on an observational, analytic and transversal study. Fiberoptic nasal endoscopy was performed on 57 patients (28 telemarketers with MTD and 29 control subjects). These random-sequence videotapes were independently rated by an expert laryngologist according to the modified Morrison and Rammage classification. In addition, a questionnaire about vocal symptoms and other details was completed.


The posterior glottal gap was the most common feature in telemarketers with MTD, while incomplete glottal gap was observed more frequently in non-dysphonic patients. More than 70% of the videotapes were rated as pathologic. There was no statistical difference in the prevalence of normal features or bowing glottal gap between patients and control subjects. Anterior-posterior supraglottic contraction was more frequent in the control group. The major symptoms found were: voice gets tired quickly, increased vocal effort and neck tension.


The heterogeneity in the laryngeal features in telemarketers with MTD seen under fibroscopy and their presence among the non-dysphonic population suggest that they cannot determine by themselves the diagnosis of MTD.

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