The aim of this study is to analyze change in pitch following feminization laryngoplasty, a technique to alter the vocal tract of male to female transgender patients. This is a retrospective review of 94 patients undergoing feminization laryngoplasty between June 2002 and April 2012 of which 76 individuals completed follow-up audio recordings. Feminization laryngoplasty is a procedure removing the anterior thyroid cartilage, collapsing the diameter of the larynx as well as shortening and tensioning the vocal folds to raise the pitch. Changes in comfortable speaking pitch, lowest vocal pitch and highest vocal pitch are assessed before and after surgery. Acoustic parameters of speaking pitch and vocal range were compared between pre- and postoperative results. The average comfortable speaking pitch preoperatively, C3# (139 Hz), was raised an average of six semitones to G3 (196 Hz), after surgical intervention. The lowest attainable pitch was raised an average of seven semitones and the highest attainable pitch decreased by an average of two semitones. One aspect of the procedure, thyrohyoid approximation (introduced in 2006 to alter resonance), did not affect pitch. Feminization laryngoplasty successfully increased the comfortable fundamental frequency of speech and removed the lowest notes from the patient’s vocal range. It does not typically raise the upper limits of the vocal range.
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Wagner I, Fugain C, Monneron-Girard L, Cordier B, Chabolle F (2003) Pitch-raising surgery in fourteen male-to-female transsexuals. Laryngoscope 113:1157–1165. doi:10.1097/00005537-200307000-00011
Brown M, Perry A, Cheesman AD, Pring T (2000) Pitch change in male-to-female transsexuals: has phonosurgery a role to play? Int J Lang Comm Dis 35(1):129–136. doi:10.1080/136828200247296
Gross M (1999) Pitch-raising surgery in male-to-female transsexuals. J Voice 13(2):246–250
Orloff L, Mann A, Damrose J, Goldman S (2006) Laser-aided voice adjustment (LAVA) in transsexuals. Laryngoscope 116:655–660. doi:10.1097/01.mlg.0000205198.65797.59
Matai V, Cheesman A, Clarke P (2003) Cricothyroid approximation and thyroid chrondoplasty: a patient survey. Otolaryngol Head Neck Surg 128(6):841–874
Dacakis G (2000) Long-term maintenance of fundamental frequency increases in male-to-female transsexuals. Voice 4:549–556. doi:10.1097/01.MOO.0000014709.200392.9B
Kunachak S, Prakunhungsit S, Sujjalak K (2000) Thyroid cartilage and vocal fold reduction: a new phonosurgical method for male-to-female transsexuals. Ann Otol Rhinol Laryngol 109(11):1082–1086
Isshiki N, Morita H, Okamura H, Hiramoto M (1974) Thyroplasty as a new phonosurgical technique. Acta Otolaryngol 78(1):451–457. doi:10.3109/00016487409126379
Isshiki N, Taira T, Tanabe M (1983) Surgical alteration of the vocal pitch. Otolaryngol Head Neck Surg 5(3):35–40
Isshiki N (1998) Mechanical and dynamic aspects of voice production as related to voice therapy and phonosurgery. J Voice 12(2):125–137
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Thomas, J.P., MacMillan, C. Feminization laryngoplasty: assessment of surgical pitch elevation. Eur Arch Otorhinolaryngol 270, 2695–2700 (2013) doi:10.1007/s00405-013-2511-3
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