Surgical Interventions for Voice Masculinization: A Scoping Review.

Area of Science:

• Otolaryngology
• Gender-affirming care
• Voice surgery

Background:

• Hormonal therapy is standard for transgender men's transition, but voice pitch dissatisfaction affects up to 20%.
• Voice therapy is a common next step, but surgical options are a last resort for persistent high vocal pitch.
• The effectiveness of surgical interventions for voice masculinization is not well-documented.

Purpose of the Study:

• To conduct a literature review of surgical and procedural options for voice masculinization in transmasculine individuals.
• To analyze outcomes of interventions for puberphonia due to limited data on voice masculinization procedures.

Main Methods:

• A scoping review was performed by two independent reviewers on surgical and procedural interventions for voice masculinization.
• Literature on surgical and procedural outcomes for puberphonia was also searched due to limited studies.
• Data collected included fundamental frequency, non-procedural treatments, symptoms, interventions, outcomes, and complications.

Main Results:

• The review included 4 articles on voice masculinization and 8 on puberphonia.
• Surgical treatments for voice masculinization included type III laryngoplasty and direct vocal fold injection with testosterone.
• Voice deepening in transmasculine patients averaged -43.75 Hz; in puberphonia patients, it averaged -68.61 Hz.

Conclusions:

• Conservative voice therapies are often successful for voice masculinization.
• Type III laryngoplasty demonstrated the most significant voice deepening.
• Less invasive procedures like injection laryngoplasty with testosterone or hyaluronic acid show potential for voice deepening.