However, lately various surgical procedures (including thyroplasty
procedures) were devised and are in practice6.
Several techniques have been developed to address the glottic insufficiency caused by UVFI, including voice therapy, medialization thyroplasty
, arytenoid adduction, and injection laryngoplasty.
Our patient underwent a thyroid cartilage window approach, which is a modification approach of the thyroplasty
type 1 that is usually used for medialization of the vocal cords.
If glottic insufficiency is present, medialization procedures such as thyroplasty
and injection can be considered.
Therefore, transgender women usually seek to adjust their voices through speech therapy and surgeries, such thyroplasty
, aiming a vocal quality enough for being identified as female on daily situations, especially those that does not give any visual clue to the listener, for example, during a phone call 11.
The laryngeal framework surgery including medialization laryngoplasty (type 1 thyroplasty
) is permanent method of medialization8.
Conventional treatments, such as vocal cord injection and various thyroplasty
procedures [6-9], have been performed to reposition the immobile vocal fold back to the midline, but these treatments ignore the long term effects of muscle atrophy on vocal fold mass and position, with outcome greatly depending on the experience and skills of the surgeon.
In search of adaptation to the self-determined gender, transgender women may choose to undergo surgical or non-surgical interventions, from which we can name sex reassignment surgery (SRS), thyroplasty
, silicone gel-filled implants, floating ribs resection, liposuction, in addition to procedures such as hormone therapy.
Cricoarytenoid dislocations and subluxations are managed with operative reduction to create a pseudoarthrosis, with or without adjunctive medialization procedures such as vocal fold injections and/or thyroplasty
. The prognosis for normal phonation is variable.
Treatment options available are surgical options such as microlaryngeal surgery (MLS), thyroplasty
(laryngeal frame work surgery), and laryngeal stent; nonsurgical treatment options are with local or systemic administration of appropriate drugs.
When more conventional measures have failed, surgery on the larynx may be performed in the form of Thyroplasty