title: Pitch elevation in trangendered patients: anterior glottic web formation assisted by temporary injection augmentation.
abstract: Pitch elevation surgery is most often indicated to assist male-to-female transgendered individuals seeking a more feminine voice quality. Behavioral therapy is primary management but if the desired voice quality is not achieved, surgery is offered. Procedures described that raise vocal pitch alter one or more of the main parameters known to physiologically control pitch; vocal fold tension, length, and mass.
  
  
  OBJECTIVE
  Web formation with injection augmentation significantly raises vocal pitch in male-to-female transgendered individuals.
  
  
  METHODS
  Retrospective cohort study. This report describes the voice results after anterior web formation with injection augmentation to reduce vocal fold length in a series of 10 transgendered patients.
  
  
  METHODS
  Retrospective review of male-to-female transgendered patients referred to St. Michaels Hospital Voice Clinic, Toronto, Canada for pitch elevation was carried out including demographic data, preoperative and postoperative acoustic data and videostroboscopic evaluation.
  
  
  RESULTS
  Comparison between preoperative to postoperative acoustic measures demonstrated a mean increase in fundamental frequency of 110 Hz after web formation. Perturbation measures and pitch range were unchanged from before surgery to after surgery.
  
  
  CONCLUSIONS
  This novel modification for endoscopic anterior web formation has been shown to be a successful procedure for permanent elevation of pitch with little or no morbidity.
authors: Department of Otolaryngology Head and Neck Surgery, Voice Disorders Clinic, St Michael's Hospital, University of Toronto, Toronto, Canada. Electronic address: chapmanj@smh.ca.
authors: Jennifer A
authors: JA
authors: Anderson
mesh_terms: D000162:Acoustics; D000328:Adult; D005260:Female; D005262:Feminization; D005931:Glottis / Q000502:physiology / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010898:Pitch Perception; D012189:Retrospective Studies; D057829:Gender-Affirming Procedures / Q000009:adverse effects / Q000379:methods*; D013061:Speech Acoustics; D013068:Speech Production Measurement; D049489:Stroboscopy; D063106:Transgender Persons; D016896:Treatment Outcome; D014741:Video Recording; D014833:Voice Quality
keywords: Endoscopic laryngeal surgery; Pitch elevation; Transsexual voice