Type III–IV functional dysphonia

This condition involves a reduction in the anteroposterior diameter of the larynx during phonation. This results in difficulty producing high-pitched tones and a frequent pattern of abnormal phonation.

It is caused by two different factors:

• As a compensatory mechanism for air leakage, which generally occurs at the level of the posterior commissure and causes an anterior tilt of the arytenoids and a shortening of the anteroposterior space. (Type III)

• As a particular form of vocal emission in which patients artificially lower the larynx in the neck and deepen the pitch of the voice in an attempt to produce a more attractive sound. This artificial lowering of the larynx leads to vocal fatigue. It is common among radio announcers, as a deeper voice is usually more noticeable. Those who are not anatomically able to produce it must lower the larynx in an unusual and non-physiological way. (Type IV)

Whether due to compensation or intentional deepening, an anteroposterior closure of the laryngeal vestibule can be observed during phonation, with a relatively normal glottis during breathing.

The cause of high tension in the laryngeal muscles is multifactorial. Personality traits and long-term vocal abuse and/or misuse lead to vocal decompensation. The laryngeal muscles attempt to compensate to restore balance but instead create a state of hyperfunction.

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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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