title: Pitch-raising surgery in fourteen male-to-female transsexuals.
abstract: OBJECTIVE
  To evaluate the indications and results of pitch-raising surgery in male-to-female transsexual patients.
  
  
  METHODS
  Retrospective study of male-to-female transsexual patients who underwent pitch-raising surgery between 1994 and 2001 at a single institution.
  
  
  METHODS
  The 14 patients had inadequate improvements after speech therapy alone. After anterior commissure advancement (n = 2), cricothyroid approximation (n = 9), or both (n = 3), results were evaluated subjectively by the patients and speech therapists and objectively by electroglottographic measurement of fundamental frequencies (usual, maximal, and minimal), postoperative gain in usual fundamental frequency, and the percentage of irregularities.
  
  
  RESULTS
  Cricothyropexy disruption occurred in two patients. Median follow-up was 6.5 months. Subjective success rates were 78.5% and 71.5% according to the patients and speech therapists, respectively. Usual, maximal, and minimal frequencies increased significantly; median postoperative gain in usual fundamental frequency was 11 Hz. Three of the four patients with a poor objective result continued to smoke after surgery.
  
  
  CONCLUSIONS
  Pitch-raising surgery induces subjective and objective improvements but should be reserved for patients in whom speech therapy is not sufficiently effective.
authors.affiliation: Otorhinolaryngology and Cervicofacial Surgerty Unit, Foch Hospital, 40 Rue Worth, 92151 Suresnes, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Wagner
authors.forename: Claude
authors.initials: C
authors.lastname: Fugain
authors.forename: Lucile
authors.initials: L
authors.lastname: Monneron-Girard
authors.forename: Bernard
authors.initials: B
authors.lastname: Cordier
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chabolle
mesh_terms: D000328:Adult; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies; D014189:Transsexualism / Q000601:surgery*; D014833:Voice Quality