•The history of the presentation of the condition and its compatibility with a Primary MTD diagnosis |
•Presenting vocal symptoms such as hoarseness, change in voice quality, limitations in pitch, loudness, flexibility, and/or stamina of the voice |
•Absence of organic pathology such as structural abnormalities, neurological and inflammatory conditions on endoscopy |
•Auditory-perceptual voice change which includes one or more of the following characteristics: having a variable or abnormal in quality (overall severity of hoarseness, roughness, breathiness, strain), having an abnormal habitual pitch with or without a restricted fundamental speaking frequency range or having abnormal loudness and loudness variability during speech |
•The presence of muscle soreness, tenderness or other evidence of hyperfunction in the thyrohyoid or cricothyroid space and/or suprahyoid muscles on physical examination |
•Laryngoscopic findings of laryngeal hyperfunction pattern (MTP types 1–III) |