Journal article
Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization
The Laryngoscope, Vol.131(5), pp.1081-1087
05/2021
DOI: 10.1002/lary.28940
PMCID: PMC9285120
PMID: 32840877
Abstract
Objectives/Hypothesis
Anterior (Wendler) glottoplasty has become a popular surgery for voice feminization. However, there has been some discrepancy between its theoretical pitch‐raising potential and what is actually achievable, and downsides to shortening the glottis have not been fully explored. In addition, descriptions of the surgery are inconsistent in their treatment of the vocal ligament. This study aimed to determine 1) how fundamental frequency (
f
o
) is expected to vary with length of anterior glottic fixation, 2) the impact of glottic shortening on sound pressure level (SPL), and 3) the effect of including the ligament in fixation.
Study Design
Computational simulation.
Methods
Voice production was simulated in a fiber‐gel finite element computational model using canonical male vocal fold geometry incorporating a three‐layer vocal fold composition (superficial lamina propria, vocal ligament, and thyroarytenoid muscle). Progressive anterior glottic fixation (0, 1/8, 2/8, 3/8, etc. up to 7/8 of membranous vocal fold length) was simulated. Outcome measures were
f
o
, SPL, and glottal flow waveforms.
Results
f
o
increased from 110 Hz to 164 Hz when the anterior one‐half vocal fold was fixed and continued to progressively rise with further fixation. SPL progressively decreased beyond 1/8 to 1/4 fixation. Inclusion of the vocal ligament in fixation did not further increase
f
o
. Any fixation increased aperiodicity in the acoustic signal.
Conclusions
The optimal length of fixation is a compromise between pitch elevation and reduction in output acoustic power. The simulation also provided a potential explanation for vocal roughness that is sometimes noted after anterior glottoplasty.
Level of Evidence
NA
Laryngoscope
, 131:1081–1087, 2021
Details
- Title: Subtitle
- Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization
- Creators
- Ingo R. Titze - University of UtahAnil Palaparthi - University of UtahTed Mau - The University of Texas Southwestern Medical Center
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.131(5), pp.1081-1087
- DOI
- 10.1002/lary.28940
- PMID
- 32840877
- PMCID
- PMC9285120
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Number of pages
- 7
- Language
- English
- Date published
- 05/2021
- Academic Unit
- School of Music; Communication Sciences and Disorders
- Record Identifier
- 9984719567402771
Metrics
4 Record Views