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Chondrolaryngoplasty & The Voice

PURPOSE: Chondrolaryngoplasty, often referred to as a “tracheal shave” or “trach shave,” is a gender-affirming surgery that aims to reduce the size of the thyroid cartilage prominence, or what is colloquially described as the “Adam’s Apple.” At Seattle Voice Lab, we were intrigued about chondrolaryngoplasty surgical techniques and potential voice changes post-surgical intervention.

OBJECTIVE: This literature review seeks to summarize the current surgical methods and their potential implications on voice and swallowing after the procedure.

METHODS: An in-depth literature review of peer-reviewed articles and a transgender community survey, published between 2015-2023, was examined to provide the most up-to-date data with focus on both transcervical and novel transoral surgical techniques.

RESULTS: Although chondrolaryngoplasty isn’t considered a voice altering surgery, the incision’s location demands significant attention to preserving voice and swallowing functionalities, especially in relation to the anterior commissure. Outcomes varied, with voice and swallowing changes ranging from non-existent to short-term post-surgery effects, and minimal long-term implications. The variance was frequently linked to the extent of anterior commissure resection and potential intubation complications.

CONCLUSION: Prospective patients should engage in thorough consultations with their physicians to understand benefits and potential voice risks, ensuring well-informed decisions regarding the procedure.

KEYWORDS: transgender, transgender woman, trans feminine, gender-affirming care, voice care, chondrolaryngoplasty, voice surgery, trach shave, tracheal shave  

CONSIDERING CHONDROLARYNGOPLASTY? 

If you are considering a chondrolaryngoplasty, here are some questions you may want to consider asking your surgeon(s) and medical team:

  • How often have you performed chondrolaryngoplasty?
  • What is your specific surgical approach? 
  • Do you routinely perform this specific procedure on people of my age/weight/ethnicity?
  • How much will this procedure cost?
  • Where specifically will the incision site be?
  • Will there be residual scarring?
  • Are pre-op and post-op appointments included in the cost?
  • Can I meet my anesthesiologist and discuss specific methods beforehand? Ask about what type of anesthesia will be used, how often the anesthesiologist has used this method, and if there are possible impacts on the vocal folds following. 
  • I have read that some voice and swallowing risks exist if the anterior commissure is compromised. How do you measure this? Please explain the potential short and long-term risks. 
  • In your personal experience, what are the voice quality risks associated with this procedure?
  • Communicate how important your voice and risks are to your physician.

The information provided is for educational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for guidance regarding your specific medical condition.