This diagnostic endoscopic image provides a superior laryngoscopic view of the larynx in a patient with Muscle Tension Dysphonia (MTD). The image demonstrates significant supraglottic hyperfunction characterized by both anteroposterior and lateral compression of the glottic aperture. The false vocal folds (ventricular folds) exhibit medial bulging, while the epiglottis and arytenoid tissues show signs of anterior-posterior narrowing, collectively obscuring the true vocal folds. The mucosa appears erythematous, consistent with laryngeal strain. Several white light reflections (artifacts) are visible across the mucosal surface due to the endoscopic light source. This clinical photograph is used to illustrate the functional laryngeal changes associated with primary MTD, where excessive muscular tension leads to abnormal glottal configuration despite the absence of structural lesions like polyps or nodules. The image is relevant for otorhinolaryngology and speech-language pathology education regarding voice disorders and laryngeal assessment.

This endoscopic clinical photograph displays the glottal and supraglottal regions of the larynx during laryngoscopy. The image demonstrates bilateral vocal cord palsy, with the true vocal cords (indicated by the white arrow) appearing in a fixed, medial position. The true vocal cords exhibit a narrow glottal gap, suggesting impaired abduction. Positioned superior to the true cords are hyperplastic vestibular folds (false vocal cords, indicated by the black arrow), which appear significantly enlarged and medially displaced. This hyperplasia results in partial obscuration of the underlying true vocal folds. Anatomical landmarks such as the arytenoid eminences and the interarytenoid area are visible but show signs of crowding due to the soft tissue enlargement. This finding is clinically relevant to the diagnosis of bilateral vocal fold immobility and compensatory muscle tension or secondary hyperplasia of the supraglottic structures, which typically presents with symptoms of dyspnea, inspiratory stridor, and dysphonia.

A clinical comparison chart displaying five endoscopic views of the human larynx, illustrating different types of Muscle Tension Dysphonia (MTD) patterns (Types I–III). Each entry consists of a diagnostic photograph and a brief descriptive text of the glottic and supraglottic configurations during phonation. Type 1 shows a posterior glottic gap where only the anterior halves of the vocal folds contact. Type IIa involves constriction primarily at the glottic level, while Type IIb demonstrates marked approximation of the false vocal cords (ventricular folds). Type IIIa is characterized by posterior-anterior narrowing with tilting and approximation of the arytenoid complex toward the epiglottic petiole. Type IIIb shows anterior-posterior narrowing with the arytenoids positioned near the posterior pharyngeal wall and the epiglottis locked in a semi-upright position. These laryngeal hyperfunction patterns are used in otorhinolaryngology and speech-language pathology to classify primary MTD, typically associated with voice misuse or abuse rather than organic pathology.

This diagnostic fiberoptic laryngoscopy image provides a superior view of the larynx during attempted phonation. The primary finding is unilateral left vocal cord paralysis. While the right vocal cord appropriately adducts toward the midline, the left vocal cord remains fixed in a more lateral, paramedian position. This asymmetry results in an incomplete glottic closure, manifesting as a visible V-shaped gap (glottal insufficiency) between the true vocal folds. Anatomical landmarks include the epiglottis in the foreground, the false vocal folds, and the arytenoid cartilages posteriorly. The left vocal fold appears relatively flaccid and lacks the tension seen on the contralateral side. This clinical finding is characteristic of recurrent laryngeal nerve neuropraxia or injury, typically presenting with symptoms of dysphonia or hoarseness due to the air leak during phonatory efforts.