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MTD is one of the most common voice disorders. It is a pattern of overuse, in which the muscles surrounding the vocal cords work too hard. Even though the muscles are contracting in an attempt to increase loudness or improve vocal quality, this pattern of excess muscular tension actually prevents the larynx from working efficiently, thereby reducing vocal resonance and impairing vocal cord vibration.

This inefficient pattern can develop for both medical and non-medical reasons. One cause is upper respiratory infections and laryngitis. Attempting to talk or even whisper when you have laryngitis can result in a retraining of the muscle patterns in the larynx, causing hoarseness to develop.