OBJECTIVE:
To evaluate the indications and results of
pitch-raising surgery in male-to-female transsexual patients.
STUDY DESIGN:
Retrospective study of male-to-female
transsexual patients who underwent pitch-raising surgery between 1994 and
2001 at a single institution.
METHODS: The 14 patients had
inadequate improvements after speech therapy alone. After anterior
commissure advancement (n = 2), cricothyroid approximation (n = 9), or both
(n = 3), results were evaluated subjectively by the patients and speech
therapists and objectively by electroglottographic measurement of
fundamental frequencies (usual, maximal, and minimal), postoperative gain in
usual fundamental frequency, and the percentage of irregularities.
RESULTS: Cricothyropexy disruption
occurred in two patients. Median follow-up was 6.5 months. Subjective
success rates were 78.5% and 71.5% according to the patients and speech
therapists, respectively. Usual, maximal, and minimal frequencies increased
significantly; median postoperative gain in usual fundamental frequency was
11 Hz. Three of the four patients with a poor objective result continued to
smoke after surgery.
CONCLUSION: Pitch-raising surgery
induces subjective and objective improvements but should be reserved for
patients in whom speech therapy is not sufficiently effective.
Citation:
Otorhinolaryngology and Cervicofacial Surgerty Unit,
Foch Hospital, 40 Rue Worth, 92151 Suresnes, France.
