Laryngeal Surgical in Transgender Women: A Systematic Review and Meta-Analysis

Abstract

Male-to-female transsexual individuals usually seek specialized care to feminize their voices. The voice can reveal the sexual orientation. The aim of this study was to identify the effects of laryngeal surgical treatment in the voice of transgender women, especially on the fundamental frequency (f0). We performed a systematic review in PubMed and Scopus in July 2016, covering the period between 2005 and 2016. Studies in English or Portuguese, about the laryngeal surgical treatment in transgender women, featuring experimental design, title, year of publication, country of origin, journal of publication, participants, intervention, results. For the meta-analysis, only studies with a randomized clinical trial; randomized, prospective cohort study; retrospective cohort or case-control were selected. Articles that mentioned the use of surgical techniques but did not use the procedure in research, animal studies, studies of revision and post-mortem studies. 423 articles were identified in the initial search; 94 were selected for analysis by two referees, independently. After applying all the selection criteria, 5 studies remained in the meta-analysis. The surgical procedures that were identified included laryngoplasty with or without thyrohyoid approximation, Wendler glottoplasty, cricothyroid approximation, laser glottoplasty reduction and vocal folds shortening and retrodisplacement of anterior commissure. Wendler glottoplasty exhibited a greater increase of f0 – 81 Hz.