Pitch-altering surgeries

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This information is for patients considering a surgery on their vocal cords or voice box to alter their pitch. The first three surgeries are primarily designed for transgender male-to-female patients to raise the pitch. Genetic males have vocal pitch and vocal resonance that are often too low to be perceived as a female.

  • Feminization laryngoplasty
    • an operating room procedure to shorten the length of the vocal cords and the size of the thyroid cartilage in a transgender patient to obtain a more feminine voice. This procedure raises pitch.
    • it has the potential to raise the pitch further than the cricothyroid approximation, but has a greater risk of needing a revision.
    • it does alter resonance to a small degree.
    • a thyrohyoid approximation can be performed at the same time to affect resonance. 
  • Thyrohyoid elevation
    • removes the upper portion of the thyroid cartilage and raises the larynx in the neck.   
  • Cricothyroid approximation (CTA)
    • an operating room procedure to pull two cartilages closer together to mimic the cricothyroid muscle action of raising the pitch.
    • when done on one side it is usually to replace the action of a paralyzed muscle.
    • when done on both sides it may be used for feminization of the male voice to raise the lowest pitch you can produce. 
  • Reduction laryngoplasty
    • an operating room procedure to reduce the profile of the Adam’s apple. This procedure does not alter the pitch but often accompanies the cricothyroid approximation procedure.
    • It is also known as a "Tracheal Shave" or "Trach Shave", though it is a procedure on the larynx (voice box) which connects to the top of the trachea (windpipe). 
  • Microlaryngoscopy
    • removes smoker's polyps, usually a disorder of female talkative cigarette smokers.
  • Pitch-lowering surgery
    • a segment of cartilage can be removed from the voice box to loosen the vocal folds and lower the pitch, and sometimes the thickness of the vocal cord can be augmented.
  • Laser tuning
    • a person's comfortable speaking pitch - male or female - can be raised a few semi-tones with an office laser procedure. It can also be used to raise the pitch of a person with smoker's polyps.
  • Consent forms
    • The legal part that you sign when you are ready and understand the risks.