Case 1 (2009) 57 yo previous thyrohyoid elevation

She is 57 years old and had a thyrohyoid elevation 4 years ago with some change in her resonance. She wanted to try a minimally invasive procedure to try and improve her feminine voice.

These recordings are set to a fairly low resolution for the internet but do demonstrate the general sound and function of the vocal cords before and after this case of laryngeal reduction surgery. Much more detail is actually visible in the office. The videos when shown are oriented with the front down and the left vocal fold is on the right of the video. Orientation is discussed here. Please note: These examples of possible results should not be construed to represent what will be acheived in any other patient. Thus there are several examples of patients on the site

There are many components to a voice exam. I have selected ones here that I feel change the most with this type of surgery.

 

Pre Surgery

2 years post
TH elvation

3 months post
Laser

 

Reading passage

Pitch is described relative to C4 or middle C on the piano.

  

Pitch: about C3 - mid male range

Pitch: Best effort about F3

(typical male speaking range about B2 - E3)

Pitch: about F3# (with effort)

(normal female speaking range about E3 - A3)

Pitch: about A3

(normal female speaking range about E3 - A3)

 

Lowest pitch

        

Pitch: (normal male low range varies C1 - C3)

Pitch:

Pitch: about

  

Highest pitch

        

Pitch: about C5

Pitch:

Pitch: about

  

Vegetative sounds

coughing & throat clearing

        

 

 

 

  

Yell

loud phonation

        

 

 

 

  

Laryngoscopy

Views

        
 
 
 
  

Stroboscopy

saying the sound /i/

        
Views during phonation.
 
 
  
The surgeon’s comments:

She initially had a thryohyoid elevation which helped some. She wanted to try to improve her voice further without the risk of the feminization laryngoplasty.

 
The patient’s comments:

At 3 months post Laser: While my voice currently sounds very good in quiet conversation, it gets weak and hoarse as soon as I try to speak loudly in a noisy environment.

By the end of day when I had the Laser Vocal Tuning procedure, my vocal cords had completely stopped vibrating and I could only speak in a whisper. It took three weeks of healing before the vocal cords made any sound at all, and for another three weeks after that it sounded like I had a severe case of laryngitis. So it took six weeks total before my voice sounded like a fairly normal male voice again. However, it was at least two months before I could speak in my upper pitch range with a female voice that sounded as good as it did before the procedure. Even then, my voice was hoarse and limited in volume, and is still slowly recovering its range and strength after three months. There was no pain or discomfort in swallowing at any point during my recovery.

The timbre of my voice below about 200hz may have become a bit thinner, but it doesn't sound much more female to my ears than it did before. Where there is a major improvement is in my newly developing ability to speak without strain in the range above 220hz. Before the procedure, there was a gap separating my lowest falsetto pitch from my highest alto pitch. I now have an overlap between alto and falsetto ranges and I'm working on making the transition between ranges sound seamless and natural.