Objective acoustic voice outcomes following direct laryngochondroplasty in transgender women: a technique-specific cohort study

Purpose: To evaluate objective technique-specific voice outcomes following direct transvestibular laryngochondroplasty (DTVLCP) in transgender women. Methods: A retrospective cohort study conducted at a tertiary referral Center. Included were all transgender women who underwent DTVLCP from December 2019 to July 2025. Their pre- and postoperative voice recordings were analyzed using standardized acoustic parameters, including fundamental frequency (F0), formant frequencies (F1, F2), jitter, shimmer and maximum phonation time (MPT). Subgroup analyses compared patients with and without subjective voice changes and those undergoing isolated versus combined procedures. Results: Voice recordings of 28 transgender women (mean age 27.8 years) were available for acoustic analysis. Postoperative vocal fold movement was preserved in all patients. Seven patients reported subjective voice change. A comparison of pre- and postoperative acoustic analysis of the cohort’s voice recordings revealed no statistically significant changes in the measured acoustic parameters (mean F0, F1, F2, jitter, shimmer, and maximum phonation time). No significant acoustic changes were found between the subgroup of patients who reported subjective postoperative voice changes (n = 7) and that of patients who did not (n = 21), and between patients who underwent isolated DTVLCP (n = 9) and those who had the procedure combined with lower facial feminization surgery (n = 19). Conclusion: DTVLCP was not associated with significant objective changes in the measured acoustic voice parameters. These findings support the safety of DTVLCP with respect to voice and provide technique-specific evidence in a field where existing data are largely derived from subjective reports and heterogeneous surgical approaches.