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The Role of the Cricothyroid Joint Anatomy in Cricothyroid Approximation Surgery

Conclusions
The anatomical structure of the CTJ influences directly (1) the position of the effective rotation axis and (2) the elongation of the vocal folds.

from the Journal of Voice

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Laser Reduction Glottoplasty for Managing Androphonia After Failed Cricothyroid Approximation Surgery

Methods
The voices of three male-to-female transsexuals, two constitutional androphonic females, and one patient with ambiguous genitalia assigned to the female phenotype were deemed to be unimproved after CTA. The patients underwent laser reduction glottoplasty (LRG) surgery tailored to each case between 2001 and 2005. Vocal outcomes were evaluated according to fundamental frequency (FF), satisfaction status, voice-related quality of life (V-RQOL) measures, and ratings of recorded voices by 10 blinded listeners after 12 months postoperatively.

Results
The LRG provided an additional mean gain of 45.17 ± 8.47 Hz (mean ± standard deviation) in the FF, equal to 4.36 ± 0.84 semitones. The mean FF increased significantly (P < 0.05) from 158.33 ± 12.14 Hz preoperatively to 203.50 ± 13.34 Hz postoperatively. All patients reported satisfactory female quality in their voices and greetings with female salutations in nonvisual communications. Their voice-related quality of life (V-RQOL) measures were high and significantly elevated (P < 0.05) after LRG. The masculine voice-quality ratings significantly shifted to feminine in the listeners' assessment. No major complications were observed during follow-up, with the exception of mild vocal fold edema that disappeared by 8 weeks postoperatively.

Conclusions
LRG can be used in androphonic cases that fail to obtain a high-pitched feminine voice after CTA.

from the Journal of Voice