Glottoplasty for Male-to-Female Transsexualism: Voice Results

Objectives. The aim of this study was to evaluate the objective voice results of Wendler's glottoplasty in male-to-female transsexuals. Method. We retrospectively reviewed our patients treated with Wendler's technique with minor modifications. Glottoplasty consisted in CO2-laser epithelial ablation of the anterior commissure and the two vocal folds in anterior third, suturing of the two vocal folds with two stitches of 3.0 resorbable thread, and application of fibrin sealant to strengthen the suture. Voice assessment was based mainly on fundamental frequency (F-0), frequency range, jitter, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP) grade of dysphonia (G), and voice handicap index (VHI). These measures were taken before surgery and on the last follow-up visit. Results. Our series included 15 patients with a mean age of 36 years. The mean follow-up period was 7.2 months. We did not observe any early complications related to the technique. The comparison between the preoperative and the postoperative measurements, using Wilcoxon signed rank test, showed a significant improvement of median F-0 from 139 to 191 Hz (P = 0.006) with an increase in the grade of dysphonia (G(pre) = 0.2, G(post) = 1, P = 0.013) and ESGP (ESGP(pre) = 8.1 +/- 3.2, ESGP(post) = 12.0 +/- 3.8, P = 0.002). Other measurements, including VHI, did not show any significant differences pre- and postoperatively. Conclusion. Wendler's glottoplasty can contribute to feminize the voice.