Related Experiment Video
Updated: Sep 9, 2025

Hemi-laryngeal Setup for Studying Vocal Fold Vibration in Three Dimensions
Published on: November 25, 2017
Cricothyroid Approximation in Trans Women With Type A Cricothyroid Joints
Claudio Storck1, Anna Schaufelbuehl1, Carla Mueller1
1Department of Otorhinolaryngology, Head and Neck Surgery, Department of Phoniatrics, University Hospital Basel, Basel, Switzerland.
Objective:
In trans women, low-pitched voice can be raised by cricothyroid approximation (CTA). The aim of the study was to analyze voice outcomes in trans women with Type A cricothyroid joints (CTJs) over a period of 5 years.
Study Design:
Prospective cohort study.
Methods:
Thirty-five trans women were included in the study after high-resolution computed tomography evaluation revealed a Type A CTJ (Type A: well-defined facet; B: no definable facet; C: flat cartilage surface). All had voice therapy before CTA. Additionally, voice assessment (mean speaking level [MSL], loudness, vocal range of speaking voice, Trans Women Voice Questionnaire [TWVQ]) was performed before and after voice therapy, and after CTA at 4 weeks, 6 months, and 1 year, and then annually for 5 years.
Results:
MSL rose with voice therapy from 134 to 150 Hz. With CTA, the MSL increased to 184 Hz 4 weeks postoperatively and to 199 Hz 6 months postoperatively. The MSL has remained stable at 203-209 Hz for 5 years. The TWVQ score decreased from 91 to 84 patients with voice therapy. After CTA, it decreased to 50 patients and has remained stable for 5 years.
Conclusion:
CTA in trans women with Type A CTJ is a valuable technique for elevating MSL, providing stable results for 5 years. Therefore, CTA should only be performed in patients with Type A CTJs who desire higher pitched voices.
Level Of Evidence:
Level 4.
Related Concept Videos
Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids,...
The Hyoid Bone
The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
Muscles of the Anterior Neck
Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

