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Updated: Jan 8, 2026

Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
La Laringe Protegida
Stephen R King1, Jenevora Williams2
1The Voice Care Centre North Devon, Tower House, The Strand, Bideford EX39 2ND, UK.
Abstract:
Laryngeal guarding is a term used informally by clinicians and teachers, which has yet to be clearly defined until now. This paper examines its potential role as an unconscious block within the body, hindering progress in voice rehabilitation and limiting the development of efficient singing and speaking behaviors. Through a narrative review, it traces a continuum of guarding from reflexive responses to learned behaviors, drawing on findings from pain science, fear-avoidance processes, dispositional and psychoanalytic formulations, and research on functional voice disorders and secondary gain. The review reframes persistent functional dysphonia as potentially underpinned by unconscious protective strategies, showing how anticipatory anxiety, trauma, and hypervigilance may contribute to maladaptive laryngeal co-contraction. In cases of hyperfunctional patterns or "guarding," the alteration is not only a loss of parasympathetic modulation but, in some instances, a reversal of its expected function. The paper proposes a theoretical account of why the system may shift from a restorative, protective parasympathetic state toward a heightened sympathetic or anticipatory mode. In this upregulated state, the larynx adopts a physiologic posture of defense rather than rest: an adaptive contraction that becomes maladaptive when sustained over time. This paper also offers practical insights into how therapists and pedagogues can identify the role of laryngeal guarding in voice disorders and support clients and students to move beyond this limitation. It outlines key features clinicians and teachers might observe in order to recognize and conceptualize laryngeal guarding within clinical or studio practice.
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