Wendler glottoplasty and voice-therapy in male-to-female transsexuals: results in pre and post-surgery assessment

Introduction: 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 deepithelialization 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. (C) 2014 Elsevier Espana, S.L.U. y Sociedad Espanola de Otorrinolaringologia y Patologia CervicoFacial. All rights reserved.