{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T07:27:01Z","timestamp":1777620421574,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R21DC019207"],"award-info":[{"award-number":["R21DC019207"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>False vocal fold (FVF) hyperfunction during phonation is thought to be a diagnostic sign of primary muscle tension dysphonia (pMTD). However, hyperfunctional patterns with phonation are also observed in typical speakers. This study tested the hypothesis that FVF posturing during quiet breathing, as measured by the curvature of FVF, could differentiate patients with pMTD from typical speakers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Laryngoscopic images were collected prospectively in 30 subjects with pMTD and 33 typical speakers. Images were acquired at the end of expiration and maximal inspiration during quiet breathing, during sustained \/i\/, and during loud phonation before and after a 30\u2010min vocal loading task. The FVF curvature (degree of concavity\/convexity) was quantified using a novel curvature index (CI, &gt;0 for hyperfunctional\/convex, &lt;0 for \u201crelaxed\u201d\/concave) and compared between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At end\u2010expiration, the pMTD group adopted a convex FVF contour, whereas the control group adopted a concave FVF contour (mean CI 0.123 [SEM 0.046] vs. \u22120.093 [SEM 0.030], <jats:italic>p<\/jats:italic>\u2009=\u20090.0002) before vocal loading. At maximal inspiration, the pMTD group had a neutral\/straight FVF contour, whereas the control group had a concave FVF contour (mean CI 0.012 [SEM 0.038] vs. \u22120.155 [SEM 0.018], <jats:italic>p<\/jats:italic>\u2009=\u20090.0002). There were no statistically significant differences in FVF curvature between groups in either the sustained voiced or loud conditions. Vocal loading did not change any of these relationships.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A hyperfunctional posture of the FVFs during quiet breathing especially at end\u2010expiration may be more indicative of a hyperfunctional voice disorder than supraglottic constriction during voicing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:3449\u20133454, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30814","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T12:54:22Z","timestamp":1686747262000},"page":"3449-3454","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quantification of False Vocal Fold Hyperfunction During Quiet Breathing in Muscle Tension Dysphonia"],"prefix":"10.1002","volume":"133","author":[{"given":"Jasper","family":"Han","sequence":"first","affiliation":[{"name":"Clinical Center for Voice Care, Department of Otolaryngology\u2010Head and Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Morrison","sequence":"additional","affiliation":[{"name":"School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing University of Texas at Dallas  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-6707","authenticated-orcid":false,"given":"Ted","family":"Mau","sequence":"additional","affiliation":[{"name":"Clinical Center for Voice Care, Department of Otolaryngology\u2010Head and Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8874-9360","authenticated-orcid":false,"given":"Adrianna C.","family":"Shembel","sequence":"additional","affiliation":[{"name":"Clinical Center for Voice Care, Department of Otolaryngology\u2010Head and Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas U.S.A."},{"name":"School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing University of Texas at Dallas  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Classification Manual for Voice Disorders\u2010I","author":"Verdolini\u2010Abbott 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