Muscle tension dysphonia, or voice strain caused by muscle tightness, can occur even when there is no damage to your vocal cords (also known as vocal folds). It’s often overlooked and left untreated. The Duke Voice Care Center team of laryngologists -- ear, nose, and throat (ENT) doctors with advanced training in voice disorders -- and highly trained speech pathologists diagnose your condition and help you learn to use your voice more comfortably in order to speak or sing without strain.