Sequential Wendler Glottoplasty and Laser Reduction Glottoplasty for Voice Feminization

Area of Science:

• Otolaryngology
• Gender-affirming care
• Surgical innovation

Background:

• Voice feminizing surgery is crucial for transgender women.
• Wendler glottoplasty (WG) and laser reduction glottoplasty (LRG) are common endoscopic procedures.
• Sequential application of these surgeries may enhance voice feminization.

Purpose of the Study:

• To evaluate the voice outcomes of sequential Wendler glottoplasty and laser reduction glottoplasty.
• To assess the efficacy of combining WG and LRG for voice feminization.

Main Methods:

• Retrospective cohort study of 35 transgender patients undergoing sequential WG and LRG.
• Patients received either WG followed by LRG, or LRG followed by WG.
• Voice Handicap Index (VHI-30), transsexual voice questionnaire (TVQ), and acoustic analyses were performed pre- and postoperatively.

Main Results:

• Significant improvements in VHI and TVQ scores were observed postoperatively.
• Mean speaking fundamental frequency (sF0) increased significantly after sequential surgeries.
• While some acoustic parameters (jitter, shimmer, NHR, CPP, CSID) showed significant worsening, they remained within normal limits. Patient self-ratings indicated all voices were perceived as feminine, with 100% gratification.

Conclusions:

• Sequential WG and LRG can significantly enhance voice feminization in transgender women.
• This combined surgical approach is a successful option for patients seeking improved voice outcomes after initial procedures.
• Sequential glottoplasty offers a viable solution for voice feminization when single procedures are insufficient.