Comparison Between two Surgical Techniques for Increasing Vocal Pitch by Endoscopic Shortening of the Vocal Folds

Casado-Morente, Juan Carlos; Benjumea-Flores, Felipe Luis; Romero-Gómez, Bárbara; Angulo-Serrano, María Soledad; O’Connor-Reina, Carlos; Alba, Carlos Casado; Galeas-López, Antonio José; Carricondo, Francisco

doi:10.1016/j.jvoice.2022.06.012

Cited by 5 publications

(8 citation statements)

References 28 publications

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“…Aires et al, (2021) [ 31 ] Brazil Phonosurgery Before 24.6 (range 13–54 sessions) 5.7 months 35.4 (27–45) Wendler glotoplasty NA TWVQ, self-perceived femininity of the Voice, analysis of CAPE-V protocol phrases GRBAS scale Voxmetria and fonoview (CTS Play) f o , there was a mean increase of 47.9 ± 46.6 Hz ( p = 0.023); MPT, jitter, shimmer, frequency range, F1 and F2, there was no statistical significance in the pre- and postoperative comparison 16. Casado-Morente et al (2022) [ 32 ] Spain Phonosurgery At least 10 speech therapy sessions. At 6 months after surgery GP 38.25 (12.18) VFSRAC + LAVA 34.70 (9.45) NA TWVQ and the perceptual assessment using a visual analog scale (PAVAS) Praat Both surgical techniques produce the shortening of the vocal folds through an endoscopic approach and result in voices with higher vocal pitch.…”

Section: Resultsmentioning

confidence: 99%

“…As for phonosurgery, five studies were retrospective [ 25 , 26 , 30 , 32 ] or prospective [ 31 ] cohorts and the other five were case-control [ 5 , 11 , 27 – 29 ] studies with a comparison of treatment results with different surgical techniques, with or without speech therapy, to groups of different ages (see Additional file 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Speech therapy for transgender women: an updated systematic review and meta-analysis

et al. 2023

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Background We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed. Methods We searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle–Ottawa scale. Results Of 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle–Ottawa Scale. Conclusion The type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Speech therapy for transgender women: an updated systematic review and meta-analysis

et al. 2023

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“…A further modification of the technique (type-2 VFSRAC) increases the tension of the vocal folds by suturing the web anteriorly into the thyroid cartilage perichondrium. Recently, the techniques have been adopted by other centres and shown superior outcomes to combined glottoplasty and LAVA [28].…”

Section: Wendler's Glottoplasty and Its Modificationsmentioning

confidence: 99%

Current approaches to gender-affirming vocal care

McBrinn,

Antoni,

Al Yaghchi

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review This review addresses the challenges faced by transgender women in achieving congruence between gender identity and voice characteristics and emphasises the importance of a multidisciplinary approach involving therapeutic and surgical interventions. Recent findings Recent literature on gender-affirming vocal care emphasises key themes such as assessment, voice feminisation therapy, and various surgical techniques, including glottoplasty and its modifications. Recent publications focused on outcomes, duration, and impact on vocal quality and scrutinised complications associated with surgical interventions. Summary Most publications in the last 18 months advocate for the integration of voice therapy and surgery for optimal outcomes. Utilising a combined approach is significantly more effective in terms of fundamental frequency gain compared to therapy alone. Modified Wendler's Glottoplasty remains the preferred and most reliable surgical intervention. However, surgery is not without its complications and vocal trade-offs, in particular, its impact on vocal projection and the risk of long-term dysphonia. Post-surgery rehabilitation improves long-term outcomes. Recent publications on alternative surgical approaches, namely laser reduction glottoplasty and feminisation laryngoplasty, show promise but the results are more difficult to generalise. Future direction Prospective multicentre studies with standardised protocols are needed to establish best evidence-based practices.

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“…Most currently published studies of surgical outcomes reflect the combined effects of voice therapy and surgical intervention. [28][29][30][31] It is therefore recommended by the authors herein that patients be encouraged to engage in voice therapy, ideally with a voice specialized SLP who has experience treating gender expansive individuals with concerns of incongruence between voice, communication, and gender. While access to high-quality voice therapy remains a barrier to treatment, the use of teletherapy maybe an alternative to in-person therapy and increase access to specialize voice therapy care.…”

Section: Do All Patients Need Voice Therapy Prior To Consideration Of...mentioning

confidence: 99%

“…This surgery has been extensively studied and favorable results have been reported by many different surgical groups and long-term benefit has been documented in the peer-reviewed literature. 29,31,38,[42][43][44] In theory, this procedure could be reversed in a similar manner for which iatrogenic anterior glottal webs are treated. The surgery is done under general anesthesia and is typically performed as an outpatient surgery with no incisions in the neck.…”

Section: Do All Patients Need Voice Therapy Prior To Consideration Of...mentioning

confidence: 99%

Gender-Affirming Voice Surgery: Considerations for Surgical Intervention

et al. 2023

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The purpose of this article is to provide an overview of the current state and available evidence surrounding surgical voice care for the transgender and/or gender expansive population. The term “gender expansive” has been proposed as an inclusive term to classify those who do not identify with traditional gender roles but are otherwise not confined to one gender narrative or experience. We aim to review indications and candidacy for surgery, surgical procedure options for altering vocal pitch, and typical postoperative expectations. The role of voice therapy and considerations for perioperative care will also be discussed.

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Comparison Between two Surgical Techniques for Increasing Vocal Pitch by Endoscopic Shortening of the Vocal Folds

Cited by 5 publications

References 28 publications

Speech therapy for transgender women: an updated systematic review and meta-analysis

Speech therapy for transgender women: an updated systematic review and meta-analysis

Current approaches to gender-affirming vocal care

Gender-Affirming Voice Surgery: Considerations for Surgical Intervention

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