title: Laser reduction glottoplasty for managing androphonia after failed cricothyroid approximation surgery.
abstract: OBJECTIVE
  To treat androphonic voice quality after failed cricothyroid approximation (CTA) surgery.
  
  
  METHODS
  Prospective case series.
  
  
  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±8.47Hz (mean±standard deviation) in the FF, equal to 4.36±0.84 semitones. The mean FF increased significantly (P<0.05) from 158.33±12.14Hz preoperatively to 203.50±13.34Hz 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.
authors.affiliation: University Hospital, Department of Otolaryngology, Istanbul, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Koçak
authors.forename: Meltem Esen
authors.initials: ME
authors.lastname: Akpınar
authors.forename: Zeynep Alkan
authors.initials: ZA
authors.lastname: Cakır
authors.forename: Müzeyyen
authors.initials: M
authors.lastname: Doğan
authors.forename: Serkan
authors.initials: S
authors.lastname: Bengisu
authors.forename: Mehmet Mazhar
authors.initials: MM
authors.lastname: Celikoyar
mesh_terms: D000328:Adult; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D007828:Laryngoscopy; D053685:Laser Therapy; D008297:Male; D017060:Patient Satisfaction; D010699:Phonation; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D057829:Gender-Affirming Procedures / Q000009:adverse effects; D013061:Speech Acoustics; D013067:Speech Perception; D049489:Stroboscopy; D011795:Surveys and Questionnaires; D013957:Thyroid Cartilage / Q000601:surgery*; D013997:Time Factors; D017211:Treatment Failure; D014421:Turkey; D014832:Voice Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult