2. Transgender/Transsexuals
It is a recognized disorder of gender identity in which
people believed themselves to be born into the
“wrong” gender body.
Most of them went to speech therapy; however, their
effort is generally unsuccessful. Finally, they resolve
to voice feminization surgery which is Cricothyroid
Approximation (CTA).
3. Pre-surgery
Stroboscope- is an
instrument used to view
the movement of your
voice box and to record
the sound of your voice.
4. Voice Frequency
Fundamental frequency (Fo) is most evident voice
quality. Cyclic movements that vocal folds perform per
second expressed in hertz.
Men: Fo ranges from 100 to 150 Hz.
Women: Fo ranges from 200 to 300 Hz.
5. Voice Feminization: CTA
The Cricothyroid Approximation surgery raises
vocal pitch by stimulating cricothyroid muscle
contraction through the approximation of the
cricoid and thyroid.
The surgery is performed in an inpatient
setting under general anesthesia.
6. CTA Procedure
The neck is prepared and
draped in a sterile manner.
I made a 1.5-2 cm
transverse incision is made
in an existing skin crease
over the cricothyroid.
7. CTA Procedure
The front of the voice box is
removed thus making the
voice box smaller. (This
removes the projection of
the Adam's apple at the
same time.
The vocal cords are then
stretched and the front third
to half of the cords are
removed to shorten them.
8. CTA Procedure
A thyrohyoid elevation may also be performed at the
same time to try raising the voice box in the neck. This
attempts to shorten the pharynx to feminize a portion of
the resonance chamber (pharynx).
A thyrohyoid elevation consists of passing sutures
around the hyoid bone to hold the voice box in an
elevated position in the neck.
9. Post surgery
• Hormonal treatment ( if any) are taken
in the morning after surgery.
• Patient is subjected to a follow up check
after seven days for suture removal.
