{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:47:01Z","timestamp":1777632421591,"version":"3.51.4"},"reference-count":56,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To analyze the Reflux Symptom Index (RSI) and the Voice\u2010Related Quality of Life (V\u2010RQOL) scores based on the perceptual and analytical parameters in primary MTD patients with no reflux.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and eighteen participants, that is, sixty patients with normal voices and fifty\u2010eight patients with primary MTD were recruited in this study. The diagnosis of primary MTD was made by perceptual voice analysis, neck palpation, video\u2010laryngoscopic examination, and exclusion of other etiologies. Acoustic analysis and the GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) scale were evaluated for all participants. The V\u2010RQOL and RSI questionnaires were then given to all participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 118 participants of 29 males (48.3%) and 31 females (51.7%) in the normal group. MTD group also included 27 males (46.6%) and 31 (53.4%) female patients. Mean (SD) RSI and V\u2010RQOL scores were 12.35 (3.84) and 11.09 (2.20) for the normal group, and 22.87 (6.97) and 22.89 (7.94) for the MTD group (<jats:italic>P<\/jats:italic> =\u2009.000). In the MTD group, V\u2010RQOL had a positive correlation with jitter for \/i\/ and \/u\/, Noise to Harmonic Ratio (NHR) for \/i\/, \/a\/, and \/u\/, and Grade, Roughness, and Strain of GRBAS scale (<jats:italic>P<\/jats:italic> &lt;\u2009.05). In addition, RSI had a positive correlation with Strain in the MTD group (<jats:italic>P<\/jats:italic> &lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MTD patients in the absence of laryngopharyngeal reflux findings may have high RSI scores. Hence, patients with high RSI scores and disproportionate acoustic and perceptual analysis would require a thorough evaluation of MTD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E1573\u2013E1579, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29220","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T11:20:18Z","timestamp":1604316018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Voice Component Relationships with High Reflux Symptom Index Scores in Muscle Tension Dysphonia"],"prefix":"10.1002","volume":"131","author":[{"given":"Payman","family":"Dabirmoghaddam","sequence":"first","affiliation":[{"name":"Associate Professor of Otorhinolaryngology\u2010Head and Neck Surgery, Otorhinolaryngology Research Center, Amir Alam Hospital Tehran University of Medical Sciences  Tehran 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