Type II functional dysphonia

Also known as glottic and supraglottic lateral contraction, it has two typical clinical presentations:

• The first involves medial glottic contraction, which produces a strained voice due to poor vocal technique. Symptoms such as neck pain and vocal fatigue are common. Its main pathophysiological mechanism is usually a pneumophonic incoordination, where the larynx functions like a valve trying to compensate for the function of the expiratory muscles. Mild redness may be observed as a result of the strain from glottic attacks. Endoscopy shows a normal larynx or slight redness of the vocal folds. Stroboscopy typically reveals a mucosal wave with reduced movement due to excessive tension in the vocal fold tissues. Minimal lesions may develop over time. Acoustic analysis is usually normal, though disturbances may be present.

• The second presentation involves medial supraglottic contraction with hyperadduction of the ventricular bands. In this case, the voice sounds hoarse, harsh, unstable, lacking brightness, diplophonic, with low intensity and very short phonation times. There is very limited pitch variation and excessive tension. The causes are usually twofold:

  • A compensatory mechanism for glottic pathology involving glottic closure deficiency, which may go unnoticed and sometimes not even be visible, as the contraction of the ventricular bands prevents visualization of the vocal folds.

  • Psychogenic factors.

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Valentina Carlile - Osteopath specializing in Osteopathy for Voice and Speech Disorders since 2002. For information and bookings, visit the Contact page.

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