Gender Affirming Laryngeal and Voice Surgery

Area of Science:

• Laryngology
• Voice Surgery
• Gender Affirmation Care

Background:

• Gender affirmation surgery includes voice modification procedures like "voice-lift" or cosmetic voice surgeries.
• Feminization surgery targets vocal fold length, tension, and thickness, alongside vocal tract resonance, to increase fundamental frequency (pitch).

Purpose of the Study:

• To compare the effectiveness of different surgical techniques for pitch elevation in gender affirmation voice surgery.
• To evaluate which surgical method, cricothyroid approximation (CTA) or glottoplasty (GL), yields maximal and stable fundamental frequency (Fo) increases.

Main Methods:

• Review of open and endoscopic surgical techniques for pitch raising.
• Surgical creation of an anterior glottic web (glottoplasty) to shorten vocal folds.
• Cricothyroid approximation (CTA) surgery to increase vocal fold tension.

Main Results:

• Glottoplasty (GL) surgery resulted in the maximal increase in fundamental frequency (Fo).
• Fundamental frequency (Fo) remained stable post-operatively after GL.
• Comparison indicated GL provided superior pitch elevation compared to CTA.

Conclusions:

• Glottoplasty (GL) is an effective endoscopic technique for achieving significant and stable pitch elevation in gender affirmation voice surgery.
• GL offers superior fundamental frequency (Fo) outcomes compared to cricothyroid approximation (CTA).
• Surgical modification of vocal fold length via glottoplasty is key for maximal pitch increase.