Presentation at 23rd WPATH Symposium, Amsterdam, July 20, 2016. Describes the five procedures then utilized to alter pitch: (1) Cricothyroid approximation (Thyroplasty Type I), (2) Vocal cord webbing / VFSAAC / Wendler Glottoplasty, (3) Laser reduction — CO2 (LAVA / Laser Glottoplasty), (4) Laser vocal cord tuning — KTP, (5) Feminization Laryngoplasty.
Home›Clinical & Educational›A Standard Examination of the Human Voice Standard Laryngeal Examination — An adequate assessment of the human voice, particularly pre- and post-surgery. Ideally two parts: audio recording and visual endoscopic examination including stroboscopy. Audio examination parameters: Speech (10-second standard reading passage), Maximum phonation time at comfortable pitch, Lowest pitch (stepwise glide), Highest pitch…
Home›Clinical & Educational›Review: Thyroid Surgery Neural Dysfunction Guidelines Detailed critical review of: Dhillon VK, Randolph GW, Stack BC Jr, et al. Head & Neck 2020. Takes on flawed terminology (“immediate VFP”) and offers corrected statements for each of the paper’s 5 consensus points. Key arguments: “Vocal fold paralysis” is wrong terminology for surgical nerve injury…
Home›Clinical & Educational›Frog in Your Throat? The founding post of the blog — mirrors the book’s thesis. Getting a hoarseness diagnosis can be “a long, tough process.” Patient stories: “The explanation for my hoarseness doesn’t make sense” and “I have tried so many treatments without success.” Key message: “A hoarse person with a voice that…
Home›Clinical & Educational›Anatomy of the Voice Box Accessible anatomy introduction. Three functions of the larynx: regulate breathing, create sound, keep food out of lungs. Describes thyroid cartilage (Adam’s apple), cricoid cartilage, hyoid bone, and how testosterone thickens/elongates vocal cords lowering pitch. Written from a café observation scene with a Japanese-speaking couple. References the book. Migration…
Home›Clinical & Educational›A Standard Examination of the Human Voice Standard Laryngeal Examination — An adequate assessment of the human voice, particularly pre- and post-surgery. Ideally two parts: audio recording and visual endoscopic examination including stroboscopy. Audio examination parameters: Speech (10-second standard reading passage), Maximum phonation time at comfortable pitch, Lowest pitch (stepwise glide), Highest pitch…
Home›Clinical & Educational›“Nanomargin” Approach to Vocal Cord Tumor Surgery Challenges traditional cordectomy protocols (Remacle et al. 1999/2000, ELS). Proposes paradigm shift from wide surgical margins to precision “nanomargin” technique using modern HD chip endoscopes, NBI/selective color imaging, and programmable CO2 laser. “Orange peel surgery”: Peeling tumor tissue from underlying healthy structures using CO2 laser. Differential…
