Operative voice pitch raising in male-to-female transsexuals

Abstract

After changing the primary sex characteristics, voice raising should be included in the concept of male-to-female sex transformation. Hormonal treatment is not able to raise the pitch, and speech therapy alone cannot, as a rule, guarantee lasting success. Since 1993, a modified cricothyroidopexy via miniplates, using Isshiki's technique, has been performed at the Ear, Nose, and Throat (ENT) Department of the Martin-Luther University of Halle-Wittenberg. This procedure is based upon an approximation of the cricoid and thyroid cartilages, resulting in an increase in vocal cord tension. Combined with chondrolaryngoplasty, it allows a reduction of the laryngeal prominence. So far, 59 patients have undergone this surgical intervention. Laryngoscopy and detailed voice studies, in addition to ultrasonic computer tomographic examinations of the larynx are performed pre- and postoperatively in order to record the anatomical, physiological, and functional data. So far, good functional results have been achieved, showing an average rise in the fundamental frequency by approximately five semitones.