Evaluating the Impact of Wendler Glottoplasty and Voice Therapy on Voice Acoustics and Quality of Life in Transgender Women: A Retrospective Observational Study.

BACKGROUND

This study aims to evaluate the outcomes of Wendler glottoplasty combined with postoperative voice therapy in transgender women, focusing on improvements in voice acoustics and quality of life after surgery.

STUDY

DESIGN

Retrospective observational study.

METHODS

This retrospective study reviewed medical records of 138 transgender women who underwent Wendler glottoplasty between January 2020 and January 2024, performed by a single surgeon. Among them, 52.2% (n = 72) underwent concurrent chondrolaryngoplasty. Speech samples, dysphonia assessment, trans woman voice questionnaire (TWVQ), and a visual analog scale (VAS) for neck aesthetic satisfaction were collected preoperatively and one year postoperatively. All patients completed at least 12 postoperative voice therapy sessions. Statistical analysis used paired t tests and effect-size calculations to assess changes across key parameters.

RESULTS

Significant improvements were observed in both vocal and aesthetic parameters. The mean fundamental frequency (F₀, sustained /e/) increased from 138.73 Hz to 207.82 Hz (Δ = +69.09 Hz or +7.00 semitones (ST); P < 0.0001; 95% confidence interval [CI], 64.18-74.00 Hz; Cohen's d = 5.27), while the mean speaking F₀ rose from 140.38 Hz to 209.24 Hz (Δ = +68.86 Hz or +6.91 ST; P < 0.0001; 95% CI, 65.12-72.60 Hz; Cohen's d = 4.96). Quality of life also improved significantly, with TWVQ decreasing from 99.06 to 56.18 (P = 0.008; 95% CI, 37.54-47.22; Cohen's d = 3.05). Among those who underwent chondrolaryngoplasty, aesthetic satisfaction markedly increased: the mean preoperative VAS score (0-10 scale) rose from 1.03 ± 0.71 to 9.83 ± 0.18 at 12 months postoperatively (P < 0.0001, Wilcoxon test).

CONCLUSION

Wendler glottoplasty combined with voice therapy significantly enhances fundamental and speaking frequencies in transgender women, while concurrent chondrolaryngoplasty contributes to substantial improvement in aesthetic satisfaction with the neck contour.