Hyperfunctional voice disorders are voice problems that occur when uncontrollable tightness (spasm) prevents the vocal cords from working properly. As air passes through the larynx, the vocal cords normally move back and forth to make sound. If you have a hyperfunctional voice disorder, the area of the brain that controls the movement of the vocal cords will not send the correct signals. This can lead to spasms of the vocal cords. A hyperfunctional voice disorder may also be called a muscular dystonia. Sometimes the spasms force the vocal cords to open when they are closed. This can cause you to lose your voice. Sometimes spasms cause the vocal cords to close too tightly. This makes your voice sound strained. You may not have spasms when you laugh, cry, or yell. What is the cause of the condition? The cause of this condition is not known. The condition may be passed on through families. What is the risk of developing the condition? You may be at higher risk if you are like this: are a middle-aged woman. There is a family history of the condition. What are the symptoms? Symptoms of this condition may include difficulty making certain sounds or saying certain words. One sound is: rough, whistling or rasping, strained or tight, obstructed. How is it diagnosed? You can be diagnosed based on: Your symptoms. Your medical history. Physical ExaminationExamine your throat and evaluate your speech. You may need the following examination procedure: Examine your throat with a small camera at the end (laryngoscope). Scope the projected image onto a monitor (direct laryngoscope). Examine the movement of your vocal cords in the reflector (indirect laryngoscope). Check the movement of your vocal cords in slow motion with a flashing light (laryngeal strobe). Examine the electrical activity of the laryngeal muscles (electromyography). You may also see a health care provider who specializes in the ears, nose, and throat (ENT specialist) or the nervous system (neurologist). How is it treated? There is currently no cure for this condition. The aim of treatment is to relieve symptoms and improve the quality of your voice. Treatment depends on your particular type of voice disorder and may include: Preferred: injections of Botulinum toxin, which blocks the brain signals that cause vocal spasms. These injections need to be repeated as the effects only last 3-4 months. Voice therapy. A speech specialist can teach you exercises that can help you speak more clearly. Physical therapy. A physical therapist can teach you how to relax and stretch the muscles in your shoulders and neck. Stress reduction techniques to prevent symptoms from getting worse. Surgery. Follow these doctors’ instructions at home: Take over-the-counter and prescription medications only if your doctor tells you to. Follow instructions for vocal exercises. Rest your voice as needed. Don’t strain your voice. For example, avoid speaking in noisy environments where you have to speak loudly for long periods of time. Practice stress management techniques, such as deep whistling and relaxation. Keep all follow-up appointments as requested by your doctor. This is very important. Seek timely medical follow-up: You have difficulty speaking. You pause or make different sounds when saying certain words or letter combinations. You lose your voice completely.