Summary
Objective
To compare two surgical techniques, the Wendler glottoplasty (GP) and its modification,
the vocal fold shortening, and retrodisplacement of the anterior commissure (VFSRAC)
associated with laser assisted voice adjustment (LAVA) cordotomy, used to feminize
the voice of transgender women by increasing the fundamental frequency (F0).
Methods
A retrospective study of 22 trans-women (20-62 years-old) was carried out. 12 of them
were treated with GP and 10 with the VFSRAC+LAVA technique. They were evaluated before
surgery and 6 months after surgery and the postoperative speech therapy. Laryngostroboscopy
examination, F0 measurements, Transgender Woman Voice Questionnaire (TWVQ) assessment and the perceptual
assessment using a visual analog scale (PA-VAS) were obtained from all patients.
Results
Laryngostroboscopic findings showed normal vocal folds before surgery and a shortening
of the vocal folds, due to the anterior glottic synechia, after surgery. Significant
increases of F0 were found in both groups but they were higher in the VFSRAC+LAVA group (47.75Hz
in GP group vs 69.70Hz in VFSRAC+LAVA group). TWVQ scores showed a significant decrease
in both groups although the difference was greater in the VFSRAC+LAVA group. Similarly,
PA-VAS scores lowered significantly in both groups but VFSRAC+LAVA group presented
the biggest decreases.
Conclusion
Both surgical techniques produce the shortening of the vocal folds through an endoscopic
approach and result in voices with higher vocal pitch. Of the two techniques presented,
the VFSRAC+LAVA produces better results although when compared with previous studies
it seems that the LAVA technique may not significantly contribute to the postoperative
results. So, the VFSRAC technique followed by postoperative speech therapy could be
recommended for trans-women who wish to feminize their voice.
Key Words
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Article info
Publication history
Published online: August 01, 2022
Accepted:
June 9,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
