Transgender Women's Voice Outcome After Laryngochondroplasty—A Systematic Literature Review

Objective: To systematically review the literature on voice outcomes following laryngochondroplasty (LCP). Data Sources: PubMed, Scopus, and Embase. Review Methods: A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published in English between January 1990 and January 27, 2026, evaluating voice quality after LCP, were eligible. Included study designs were randomized controlled clinical trials, cohort studies, case-control studies, and case series. Extracted data encompassed study design, sample size, surgical technique, voice assessment methods, and reported outcomes. Results: Of 344 articles identified, 126 duplicates were removed, and 162 articles were excluded by screening title and abstract. The full texts of the remaining 44 articles were reviewed, and 20 met the eligibility criteria, representing a cohort of 760 patients. Most studies relied on subjective or qualitative voice assessments; only two incorporated objective acoustic analyses. Postoperative voice changes were reported in 98 of 777 patients (12.6%), more in patients operated via the transcervical approach (13%), than via the transvestibular approach (5.2%). Fewer reports of voice changes were found when utilizing the transcervical technique with vocal fold localization than without (2.8% vs 29.6%, respectively). More reports of voice changes were found in studies from lead authors affiliated with Otolaryngology-Head and Neck Surgery departments than in those affiliated with plastic surgery departments (15.3% vs 9.9%, respectively). Conclusions: Voice changes may occur following LCP, and the surgical approach may affect the risk. Larger prospective studies using standardized and objective voice measures are needed to confirm these findings.