Pitch-raising surgery in male-to-female transsexuals.

Several surgical methods for pitch raising have been described such as cricothyroid approximation, anterior commissure advancement, scarification, and injection of triamcinolone into the vocal folds. These procedures have different disadvantages and risks. A new method for pitch raising via endolaryngeal shortening of the vocal folds is presented. Long-term results of the first 10 patients are presented. In 1 person, who smoked immediately after surgery, coughed, and did not observe voice rest, there was a dehiscent suture. In 9 transsexuals after surgery the voice range was reduced for the lower frequencies, and a permanent 9.2-semitone increase of the mean, spontaneous fundamental frequency was obtained.