Transcutaneous Electrical Nerve Stimulation therapy for Muscle Tension Dysphonia in professional voice users

To determine the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy for Muscle Tension Dysphonia (MTD) in professional voice users. Patients who satisfy the inclusion and exclusion criterias will be randomised into 2 treatment groups. Group A: Control group and Group B: Intervention group. Treatment will be given at ENT Clinic. All patients in group A and B will undergo voice therapy by a speech therapist. Patients will receive 6 sessions of voice therapy for 20 minutes each over the period of three months following diagnosis. These sessions will be conducted at an interval of 2 weeks. Patients in Group B will receive concurrent TENS therapy. Patients will receive frequency and pulse width patterns of 10 Hz and 200 ms for 20 minutes. Two pairs of electrodes will be applied to trapezius muscle and both sides of the submandibular. Patients will receive 6 sessions of TENS therapy over the period of three months following diagnosis. These sessions will be conducted at an interval of 2 weeks. After three months of treatment, each patient will be evaluated using the same parameters and all data will be recorded in patients’ logbooks; 1. (VHI-10) questionnaire 2. Presence and absence of laryngeal symptoms 3. Subjective voice assessment which includes GRBAS voice score, maximum phonatory time (MPT) 4. Qualitative measurement of voice quality using acoustic analysis phone ‘application software’ 5. Neck examination using neck tension palpation system 6. Laryngoscopy examination Patients’ compliance to both therapies will be assessed and recorded in a logbook by a speech therapist. Subjects may be withdrawn if subject is not compliant to voice therapy and does not come for scheduled TENS therapy. Subjects may be contacted to ensure compliance and confirm visit for the sessions.