1024 Transgender female with a previous CTA that had faded

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Age: 
63
Male or female: 
male-to-female
Type of surgery: 
Laser cord reduction
Prior voice surgery: 
Cricothyroid approximation
Microlaryngoscopy with LAVA
Trach shave: 
Trach shave with no complications
Year of surgery: 
2011
Follow up (in months): 
7
Dr. Thomas' comments: 

She had a cricothyroid approximation about 10 years ago after which her voice fell back to its original pitch within a few months. She then had a LAVA procedure which helped for a period of time although she feels that this was also only a temporary improvement. The before voice in this recording is after these two surgeries.