Sequential Wendler Glottoplasty and Laser Reduction Glottoplasty for Voice Feminization


Laryngoscope, vol.134, no.3, pp.1133-1138, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 134 Issue: 3
  • Publication Date: 2024
  • Doi Number: 10.1002/lary.30958
  • Journal Name: Laryngoscope
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, MLA - Modern Language Association Database, Veterinary Science Database
  • Page Numbers: pp.1133-1138
  • Keywords: feminization, laser, transgender, transsexualism, voice
  • Hacettepe University Affiliated: Yes


Objective: Voice feminizing surgery is frequently needed for transgender female patients. Among several surgical options, Wendler glottoplasty (WG) and laser reduction glottoplasty (LRG) are two endoscopic procedures. However, because a single procedure may not produce sufficient benefit, the two surgeries may sometimes be sequentially performed. This study was carried out to present the voice results of such sequential surgeries. Methods: This is an individual retrospective cohort study, performed at a tertiary referral center, that is a university hospital. 18 transgender patients were treated with WG initially and then underwent LRG; 17 had LRG first then WG. All 35 cases were performed during a 15-year period and followed for at least 1 year postoperatively. Voice Handicap Index (VHI-30), transsexual voice questionnaire (TVQ), and acoustic analysis with /a/ and running speech were obtained pre- and postoperatively. Results: VHI and TVQ improved significantly postoperatively (p < 0.05). Their preoperative, first, and second postoperative mean sF0 were 146, 175, and 215 Hz, respectively; these differences were statistically significant (p < 0.001). Their postoperative mean jitter percent, shimmer percent, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), and cepstral spectral index of dysphonia (CSID) worsened significantly compared to preop values (p < 0.05); however, mean postoperative acoustic results were still within normal limits. Patients' self-ratings of their postsurgery voices revealed all feminine, leading to a patient gratification score of 100%. Conclusion: If transgender female patients are unsatisfied with their voice after WG or LRG, the addition of the alternative procedure may significantly feminize their voice. Sequential WG and LRG is a successful surgical option for voice feminization. Level of Evidence: 4 Laryngoscope, 2023.