Management of Functional Aphonia and Related Severe Muscle Tension Disorders: A Practical Approach with Historical Underpinnings

Abstract

Management of functional aphonia and severe muscle tension dysphonia requires a skilled and flexible treatment approach. Key components of management include accurate diagnosis, clinical probing, and targeting underlying physiological processes inherent in voice production. Diagnostic factors include laryngeal imaging, acoustic and aerodynamic testing (when appropriate), as well as perceptual and therapeutic potential assessment. This article explores historical management techniques in the context of modern approaches, demonstrating management approaches that focus on balancing respiration and phonation while decreasing overlying inappropriate muscle tension. Patient-focused treatment approaches are critical, as is considering the impact on quality of life, generalization, and interdisciplinary care. Limited data exist detailing efficacy; however, a multivariate and dynamic approach is key for successful management of this population.