Journal article
Cricothyroid joint anatomy as a predicting factor for success of cricoid-thyroid approximation in transwomen.
- Tschan S Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
- Honegger F Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
- Storck C Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics, University Hospital Basel, Basel, Switzerland.
- 2015-08-01
Published in:
- The Laryngoscope. - 2016
Crico-thyroid joint
cricoid-thyroid approximation
laryngeal biomechanics
laryngeal framework surgery
transwomen
vocal pitch
Adult
Cricoid Cartilage
Feasibility Studies
Female
Humans
Imaging, Three-Dimensional
Laryngeal Muscles
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Sex Reassignment Procedures
Thyroid Cartilage
Tomography, X-Ray Computed
Transgender Persons
Treatment Outcome
Vocal Cords
Voice Quality
Young Adult
English
OBJECTIVES/HYPOTHESIS
Cricoid-thyroid approximation (CTA) performed to elevate the vocal pitch in transwomen fails in about one-third of the patients. The purpose of this study was to test the feasibility of predicting the likelihood of success of CTA by preoperative determination of the crico-thyroid joint (CTJ) type using three-dimensional (3-D) images derived from high-resolution computer tomography (HRCT).
STUDY DESIGN
Prospective cohort study of 18 transwomen who underwent CTA at our institution.
METHODS
All patients had a preoperative and a postoperative HRCT of the larynx, as well as pre- and postoperative measurements of the fundamental vocal pitch (F0 ).
RESULTS
Three-dimensional images showed type A CTJs in 11 patients and type B or C CTJs in seven patients (see below for the definition of these types). Cricoid-thyroid approximation raised the F0 on average by 76 Hz in patients with type A CTJs and by 45 Hz in patients with type B/C CTJs. Moreover, CTA produced a vocal fold elongation of 17% in larynges with type A joint but only of 3% in larynges with type B/C joints.
CONCLUSION
Three-dimensional images allow the differentiation of type A versus type B/C CTJs but not the distinction between type B and type C CTJs. Both vocal pitch elevation and vocal fold elongation following CTA are significantly greater in patients with type A CTJs than in patients with type B/C CTJs. Based on these preliminary results, we recommend identifying the CTJ type on 3-D images and limiting CTA to patients with type A CTJs.
LEVEL OF EVIDENCE
4. Laryngoscope, 126:1380-1384, 2016.
Cricoid-thyroid approximation (CTA) performed to elevate the vocal pitch in transwomen fails in about one-third of the patients. The purpose of this study was to test the feasibility of predicting the likelihood of success of CTA by preoperative determination of the crico-thyroid joint (CTJ) type using three-dimensional (3-D) images derived from high-resolution computer tomography (HRCT).
STUDY DESIGN
Prospective cohort study of 18 transwomen who underwent CTA at our institution.
METHODS
All patients had a preoperative and a postoperative HRCT of the larynx, as well as pre- and postoperative measurements of the fundamental vocal pitch (F0 ).
RESULTS
Three-dimensional images showed type A CTJs in 11 patients and type B or C CTJs in seven patients (see below for the definition of these types). Cricoid-thyroid approximation raised the F0 on average by 76 Hz in patients with type A CTJs and by 45 Hz in patients with type B/C CTJs. Moreover, CTA produced a vocal fold elongation of 17% in larynges with type A joint but only of 3% in larynges with type B/C joints.
CONCLUSION
Three-dimensional images allow the differentiation of type A versus type B/C CTJs but not the distinction between type B and type C CTJs. Both vocal pitch elevation and vocal fold elongation following CTA are significantly greater in patients with type A CTJs than in patients with type B/C CTJs. Based on these preliminary results, we recommend identifying the CTJ type on 3-D images and limiting CTA to patients with type A CTJs.
LEVEL OF EVIDENCE
4. Laryngoscope, 126:1380-1384, 2016.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1002/lary.25518
- PMID 26227170
- Persistent URL
- https://sonar.ch/global/documents/251889
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