INTRODUCTION: The link between nasal obstruction and muscle tension dysphonia (MTD) has not been previously investigated despite the well-established relationship between respiratory diseases and voice disorders. METHODS: Patients presenting to the Voice and Swallowing Unit at a tertiary referral center between July 2022 and October 2023, and diagnosed with primary MTD were recruited. The prevalence and severity of nasal obstruction was assessed using the Visual Analogue Scale (VAS) and sinonasal symptoms were assessed using the Sinonasal Outcome Test-22 (SNOT-22) questionnaire. A group matched by age and gender, with no history of dysphonia and normal laryngeal examination was recruited as a control group. RESULTS: A total of 65 patients were enrolled in this study. These were divided into a study group of 31 patients diagnosed with primary MTD and a control group of 34 subjects with no history of dysphonia and normal laryngeal examination. Using the VAS scale for nasal obstruction, 19 patients of the study group (61.3%) had a score above 4 and were found to have moderate to severe nasal obstruction compared to only five in the control group (14.7%) (p<
0.001). Using the SNOT-22 questionnaire, 61.3% of patients with MTD had moderate to severe sinonasal symptoms as compared to only 5.9% of the control group (p<
0.001). CONCLUSION: Patients with primary MTD are more likely to have nasal obstruction and sinonasal symptoms in comparison to patients with no dysphonia and a normal laryngeal examination.