Summary
Objectives
Transgender women often seek to feminize their voice so that it becomes congruent
with their gender identity. Many receive voice therapy (VT) with good results. Some
also need pitch-raising surgery. The purpose of this study was to investigate long-term
effects and to compare outcomes between cricothyroid approximation (CTA) and glottoplasty
(GP).
Methods
This study included retrospective data from 24 patients (35–67 years). Eleven patients
had undergone CTA and 13 had undergone GP. Audio recordings were performed in a sound-treated
booth and patients answered questionnaires before and after VT, post surgery, and
at 1-year follow-up. Fundamental frequency (fo) measures were extracted from voice range profiles (VRPs) and speech range profiles
(SRPs) and were compared with cisgender data.
Results
Minimum fo in VRP increased significantly only after CTA (95 to 123 Hz). Maximum fo in VRP was significantly lowered after GP (765 to 652 Hz), even more after CTA (677
to 475 Hz). Speaking mean fo increased significantly after VT and post surgery, and was thereafter stable (CTA
167 Hz, GP 169 Hz). The maximum fo in the SRP increased only after VT. The frequency ranges were strongly reduced after
CTA. Patients were in general satisfied at follow-up and rated the GP outcomes more
favorably than CTA.
Conclusions
Both surgical methods have advantages and disadvantages. The very restricted speaking
and physiological frequency ranges, which do not favor an optimal female voice, were
mainly found after the irreversible CTA. Thus, CTA is no longer performed at our hospital,
whereas surgical techniques based on GP are being developed further. We strongly recommend
the use of VRPs to evaluate treatment effects.
Key Words
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Article info
Publication history
Published online: August 01, 2018
Accepted:
March 8,
2018
Footnotes
Conflict of interest: This is original work and the manuscript has not been submitted to other journals. The authors do not have any conflicts of interest.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
