Tensioning Glottoplasty: A Novel Surgical Technique for Voice Feminization

Creative Commons License

Birkent E., Birkent A. H., Yelken K., Enver N.

LARYNGOSCOPE, cilt.1, sa.1, ss.1-6, 2026 (Hakemli Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 1 Sayı: 1
  • Basım Tarihi: 2026
  • Dergi Adı: LARYNGOSCOPE
  • Sayfa Sayıları: ss.1-6
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • İstanbul Medipol Üniversitesi Adresli: Evet

Özet

Objectives

To describe a novel surgical technique for voice feminization that combines anterior glottic shortening with anteriorly directed tensioning, and to report its early acoustic outcomes.

Methods

A retrospective analysis of 20 transgender women (mean age 28.7 ± 5.1 years; range 22–41 years) who underwent tensioning glottoplasty for voice feminization was performed. The procedure uses a combined endolaryngeal and external approach: following excision of the anterior vocal fold mucosa, transcartilaginous sutures are placed under endoscopic guidance and tied externally over the thyroid cartilage. Fundamental frequency was measured preoperatively and at 1 month postoperatively. Statistical analysis was performed using a paired-samples t-test following Shapiro–Wilk normality testing.

Results

Mean fo increased from 126.2 ± 22.6 Hz preoperatively to 241.2 ± 34.1 Hz postoperatively, a mean increase of 115.0 Hz (95% CI: 102.19–127.87 Hz; p < 0.001; Cohen's dz = 4.19). All 20 patients demonstrated postoperative pitch elevation.

Conclusion

Tensioning glottoplasty produced substantial and clinically meaningful pitch elevation. By combining vibratory length reduction with augmentation of longitudinal tension, this technique may offer a distinct biomechanical advantage within the spectrum of gender-affirming voice surgery.