Comparison of cricothyroid approximation and glottoplasty for surgical voice feminization in male‐to‐female transsexuals

Mora, Elena; Cobeta, Ignacio; Becerra, A.; Lucio, María Jesús

doi:10.1002/lary.27172

Cited by 27 publications

(34 citation statements)

References 28 publications

(82 reference statements)

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“…Prior studies have noted worsening of dysphonia grade on the GRBAS scale after glottoplasty 8,9 . However, the surgical technique used in both of these studies involves removal of both the superior, infraglottic, and medial mucosal surfaces of the anterior vocal folds rather than just the medial surface, as in this study.…”

Section: Discussionmentioning

confidence: 90%

Effect of Wendler Glottoplasty on Acoustic Measures of Voice

Chang

Brown

et al. 2020

The Laryngoscope

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Objectives Voice therapy has been the primary treatment for voice feminization in transfemale patients due to concerns that surgery worsens voice quality. We aim to determine the impact of Wendler glottoplasty on acoustic measures of voice. Study Design Retrospective case series. Methods Transgender female patients treated for vocal feminization with Wendler glottoplasty at a single tertiary care center were identified. Pre‐ and postoperative measures were taken with the Kay Elemetrics Real‐Time Pitch, Analysis of Dysphonia in Speech and Voice, and Multidimensional Voice Program. Results Twenty‐eight patients were included in this study. There were no statistically significant changes in fundamental frequency variation, peak amplitude variation, soft phonation index, noise‐to‐harmonics ratio, cepstral peak prominence, or cepstral spectral index of dysphonia at a significance level of P < .05. Average speaking fundamental frequency (SF0) increased from 143 Hz after voice therapy to 163 Hz after surgery (P = .0009). Lower range decreased in 61% and increased in 26% of patients. Upper range decreased in 52% and increased in 48% of patients. Conclusions Wendler glottoplasty does not worsen voice quality based on acoustic measures. Although most patients experience an increase in average SF0, effects on vocal range are variable with approximately half of patients experiencing a reduction and half experiencing an increase in upper pitch limit. Level of Evidence 4 Laryngoscope, 131:583–586, 2021

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Section: Discussionmentioning

confidence: 90%

Effect of Wendler Glottoplasty on Acoustic Measures of Voice

Chang

Brown

et al. 2020

The Laryngoscope

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“…Existing surgical literature suggests that the effects of glottoplasty in F0 elevation will have stabilized approximately within this time frame. In a study of patients who underwent Wendler glottoplasty with no VT, Mora et al reported F0 elevation of 45 Hz at 6 months and 41 Hz at 12 months 26 . Comparatively, literature on VT suggests results may diminish in as little as 15 months.…”

Section: Discussionmentioning

confidence: 99%

Addition of Wendler Glottoplasty to Voice Therapy Improves Trans Female Voice Outcomes

Brown

Chang

et al. 2020

The Laryngoscope

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Objectives/Hypothesis VT is often considered the preferred treatment for vocal feminization in transgender patients. However, Wendler glottoplasty offers a surgical option for increasing fundamental frequency and perception of vocal femininity. We aimed to determine whether the addition of glottoplasty to VT results in greater fundamental frequency elevation and improvement in quality‐of‐life measures. Study Design Retrospective case series. Methods Forty‐eight trans female patients were treated for vocal feminization. Twenty‐seven patients underwent VT, and 21 patients underwent VT with additional glottoplasty (VTWG). Pre‐ and posttreatment acoustic measures, Trans Woman Voice Questionnaire (TWVQ), and Voice Handicap Index‐10 (VHI‐10) data were compared. Results Glottoplasty in combination with VT elevated average speaking fundamental frequency (SF0) to a greater extent than VT alone (P < .0001). The VTWG group achieved a 42‐Hz increase in SF0, whereas the VT group achieved a 15‐Hz increase in SF0. In both the VT and VTWG groups, the lower bound of physiologic range increased by 18 Hz (P = .0008 and P = .016, respectively). The addition of glottoplasty also resulted in greater improvement in voice‐related quality of life. Improvement in TWVQ and VHI‐10 was significantly greater in the VTWG group than the VT group (P = .007 and P = .029, respectively). TWVQ showed statistically significant improvement in the VTWG group only. Conclusions VT results in SF0 elevation and improvement in VHI‐10. The addition of glottoplasty to VT results in further improvements in SF0 and VHI‐10 and statistically significant improvement in TWVQ. Level of Evidence 4 Laryngoscope, 131:1588–1593, 2021

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“…When a patient does not have a Type A CTJ, the laryngologist should consider another surgical method, eg, a glottoplasty or a feminization larygoplasty. 16 To undergird this statement, we need a study analyzing only CTA in Type A CTJs patients over a long term.…”

Section: Discussionmentioning

confidence: 99%