[Resorbable material for osteosynthesis or titanium for the cricothyroidopexy?].

Voice feminization surgery in male-to-female transsexuals often involves cricothyroidopexy to raise vocal pitch. A known complication is suture cutting through cartilage early after surgery, before scar tissue stabilizes the joint. This can reduce vocal cord tension and lower pitch. To prevent this, surgeons use mini plates made of titanium or resorbable materials like LactoSorb. Prior research has shown that these materials protect cartilage from suture damage. However, it was unclear whether the choice of material affects long-term voice outcomes or the need for revisions. No prior work had resolved whether titanium or resorbable plates provide better results. This gap motivated a study to compare the two materials in real-world surgical settings. The study aimed to determine if material type influences voice pitch elevation or surgical stability. The study also examined how often revisions were needed. The goal was to provide evidence-based guidance for surgeons choosing fixation materials.

The study aimed to compare the effectiveness of titanium versus LactoSorb mini plates in cricothyroidopexy for male-to-female transsexuals. The specific problem was the risk of suture cutting through cartilage early postoperatively, which can reduce vocal cord tension and lower voice pitch. The motivation was to determine whether the material used for fixation affects voice pitch elevation or the need for revision surgeries. The researchers proposed that both materials might be equally effective in preventing suture-related complications. The study sought to evaluate voice pitch outcomes in patients using either titanium or resorbable plates. The goal was to assess whether material choice influences the degree of pitch change or long-term stability. The study also aimed to measure how often patients required additional procedures. The findings would help surgeons choose fixation materials based on clinical outcomes rather than assumptions.

The study involved 67 male-to-female transsexual patients who underwent cricothyroidopexy between October 1993 and December 2001. Patients were divided into two groups: 28 received titanium mini plates and 39 received LactoSorb plates. The average patient age was 39 years, ranging from 24 to 67. A complete voice diagnostic work-up was conducted before and after surgery. Voice pitch was measured using standardized methods. The study tracked the degree of pitch elevation in half tones. Researchers also recorded the number of revision surgeries needed. Long-term outcomes were assessed to determine material impact on stability. Data were compared between the two groups to evaluate differences in voice results and complications.

Voice pitch was successfully elevated in 94% of patients, with an average increase of five half tones. In 39% of cases, the pitch rose by more than 12 half tones (very good) or between six and 12 half tones (good). In 55% of patients, the increase was minimal (one to two half tones) or very small (three to five half tones). The material used for mini plates had no significant effect on the degree of pitch elevation. Long-term results also showed no difference between titanium and LactoSorb plates. The number of revision surgeries was not influenced by the material type. Both materials provided similar protection against suture cutting through cartilage. The study found no evidence that one material outperformed the other in clinical outcomes.

The study found no evidence that titanium or LactoSorb mini plates differ in their impact on voice pitch elevation or long-term stability. Both materials provided similar protection against suture-related cartilage damage. The authors proposed that surgeons may choose either material without affecting clinical outcomes. The results suggest that material selection should be based on surgeon preference or patient-specific factors. No prior work had resolved whether one material was superior in this context. The findings support the use of either titanium or resorbable plates in cricothyroidopexy. The authors emphasized that the choice of fixation material does not influence the success of voice feminization surgery. The study contributes to the evidence base for surgical material selection in transgender voice surgery.