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Updated: May 10, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Published on: October 24, 2025

Type 3 thyroplasty for patients with mutational dysphonia.

Kazuhiro Nakamura¹, Kiyoaki Tsukahara, Yusuke Watanabe

¹Department of Head and Neck Surgery, Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. eddy@tokyo-med.ac.jp

Journal of Voice : Official Journal of the Voice Foundation

|June 25, 2013

Summary

Type 3 thyroplasty effectively lowers vocal pitch in adult men with persistent high-pitched voices when voice therapy fails. This surgical intervention reduces vocal fold tension, resulting in a lower speaking fundamental frequency.

Keywords:

Androgen Framework surgery Kayser-Gutzmann method Mutation Phonosurgery Voice therapy

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Area of Science:

Otolaryngology
Speech and Language Pathology

Background:

Mutational dysphonia can cause a persistent high-pitched voice in adult men, even after puberty.
Voice therapy is the standard treatment but may be ineffective in some cases.

Observation:

Three adult men with mutational dysphonia presented with high speaking fundamental frequencies (SFFs).
Preoperative anterior-posterior compression tests indicated a potential for pitch reduction.

Findings:

Following Type 3 thyroplasty (TP3), SFFs significantly decreased in all three patients.
Postoperative SFFs ranged from 87.5 Hz to 115.4 Hz, indicating successful pitch lowering.

Implications:

Type 3 thyroplasty is a viable surgical option for treating mutational dysphonia when conservative methods fail.
This procedure effectively reduces vocal fold tension to achieve a lower vocal pitch.