Gender-Affirming Laryngeal Surgery: The Effects of the Modified Wendler's Glottoplasty on Voice Pitch and Quality of Life.

Abstract

To describe the effects of the Modified Wendler's Glottoplasty (MWG) technique on voice pitch and quality of life (QoL) using preoperative and postoperative outcome measures. Single institution retrospective review. Tertiary care private healthcare facility. A retrospective cohort study was performed of all transgender patients undergoing voice feminisation surgery using the MWG technique by a single surgeon from September 2020 to August 2024. Demographic data was extracted in addition to preoperative and postoperative speaking and reading fundamental frequencies (f₀) and Ten Question Voice Handicap Index (VHI-10) and TransWoman Voice Questionnaire (TWVQ) scores. 300 patients were included in the study with an average age of 36.9 years. Mean preoperative free continuous speech f₀ was 125.3 Hz; at 4 weeks, mean f₀ statistically significantly increased from baseline to 186.2 Hz (P < .0001) and at 4 months, mean f₀ statistically significantly increased from baseline to 182.6 Hz (P < .00034). Mean preoperative reading f₀ was 127.7 Hz; at 4 weeks, mean f₀ statistically significantly increased from baseline to 191.2 Hz (P < .0001) and at 4 months, mean f₀ statistically significantly increased from baseline to 187.8 Hz (P < .0001). Mean VHI-10 score was 20.32 preoperatively; this significantly reduced to a mean score of 11.53 at 4 months (P < .0001). Mean TWVQ score was 93.27 preoperatively; this significantly reduced to a mean score of 52.13 at 4 months (P < .0001). This study provides a comprehensive assessment of the outcomes associated with MWG in transgender women seeking gender-affirming voice surgery and demonstrates a significant improvement in vocal pitch and voice-related QoL following surgery.