Chondrolaryngoplasty: Vocal Considerations, Outcomes, and Effects on Acoustic Measures of Voice.

Abstract

Chondrolaryngoplasty reduces the laryngeal prominence creating a smoother, more feminine neck contour. Although voice change is a feared complication, validated voice outcomes remain limited and lack objective acoustic data. This study documents peri-operative voice metrics, including patient-reported outcomes, expert perceptual ratings, and quantitative acoustic measures. A retrospective review was conducted of patients undergoing chondrolaryngoplasty between June 2021 and August 2025 through a tertiary care interdisciplinary laryngology practice. Pre-/post-operative voice data were collected, including stroboscopic findings, Voice Handicap Index-10 (VHI-10), Trans-Women Voice Questionnaire (TWVQ), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and objective acoustic analyses encompassing 11 parameters of pitch/frequency and cepstral parameters. Student's t-tests and Wilcoxon signed-rank tests assessed changes across measures. Thirty-five surgeries were analyzed. Postoperatively, 18 patients (51.4%) reported no perceived voice change, 17 (48.6%) described transient alterations with return to baseline. Mean change in VHI-10 was 0.08 ± 6.02 (p = 0.96), TWVQ was 8.67 ± 12.2 (p = 0.12). CAPE-V ratings showed no significant differences in overall severity (-2.6, p = 0.35), roughness (-2.9, p = 0.12), breathiness (0.5, p = 0.70), or strain (-0.7, p = 0.79). No statistically significant changes were observed across all 11 acoustic parameters (all p > 0.25). CSID, CPP, and pitch-related measures remained stable. Chondrolaryngoplasty provides aesthetic neck contour improvement without producing measurable changes in voice quality. Subjective patient reports, validated voice outcome measures, CAPE-V ratings, and acoustic analyses collectively support that the procedure does not adversely affect voice, pitch, or acoustic stability.