title: Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment.
abstract: BACKGROUND
  With the development of new ENT techniques, many male transsexuals who wish to become women usually request a surgical procedure to raise the fundamental frequency of the voice (feminization). The ENT specialist and the voice-therapist have to use an interdisciplinary approach to this growing social demand. The aim of this study was to show the results in a group of transsexual patients after Wendler's anterior synechiae, with additional voice-therapy treatment.
  
  
  METHODS
  Ten male transexulas who wish to become women patients who had Wendler glottoplasty and voice-therapy were assessed. The surgical procedure consisted of a de-epithelialization of the anterior third of both vocal folds; this area was sutured and the surface of both vocal folds was vaporised with laser diode. Pre- and postsurgery voice assessment consisted of measuring fundamental frequency (Fo) and maximum phonation time, administering the transgender self-assessment questionnaire (TSEQ) and obtaining perceptual voice assessment by inter-rater agreement.
  
  
  RESULTS
  All the male transsexuals who wish to become women patients significantly increased their Fo (106 Hz on average) after the treatment. Furthermore, significant improvements were shown in self-reported satisfaction and in the degree of voice feminization. No improvements in the maximum phonation time were observed.
  
  
  CONCLUSIONS
  Wendler glottoplasty is a surgical procedure to contribute to feminising the voice, with good medium-term results and without noteworthy medical complications. The increase in vocal tone was observed using several pre- and post-surgery control measures and voice therapy.
authors.affiliation: Servicio de Otorrinolaringología, Hospital QUIRÓN-Marbella, Málaga, España.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Casado
authors.affiliation: Servicio de Otorrinolaringología, Hospital QUIRÓN-Marbella, Málaga, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: O'Connor
authors.affiliation: Logopedia, Universidad de Málaga, Málaga, España.
authors.forename: María S
authors.initials: MS
authors.lastname: Angulo
authors.affiliation: Facultad de Psicología, Universidad de Málaga, Málaga, España. Electronic address: jadrian@uma.es.
authors.forename: José A
authors.initials: JA
authors.lastname: Adrián
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D013061:Speech Acoustics; D063106:Transgender Persons; D014827:Vocal Cords / Q000601:surgery; D014831:Voice; D014833:Voice Quality
keywords: Feminización de la voz; Glotoplastia de Wendler; Logopedia; Male-to-female transsexualism; Transexualidad; Voice feminization; Voice therapy; Wendler glottoplasty