Voice Feminization Surgery
      Otorhinolaryngologist
      Voice Change Surgeon
       (transgender)
      Snoring Surgeon
      Nose, Sinus Surgeon



                               Ornouma Sriwanishvipat, MD.,ENT
                                yanhee_ent@yahoo.com
Transgender/Transsexuals
 It is a recognized disorder of gender identity in which
 people believed themselves to be born into the
 “wrong” gender body.

 Most of them went to speech therapy; however, their
 effort is generally unsuccessful. Finally, they resolve
 to voice feminization surgery which is Cricothyroid
 Approximation (CTA).
Pre-surgery
 Stroboscope- is an
  instrument used to view
  the movement of your
  voice box and to record
  the sound of your voice.
Voice Frequency
 Fundamental frequency (Fo) is most evident voice
 quality. Cyclic movements that vocal folds perform per
 second expressed in hertz.

 Men: Fo ranges from 100 to 150 Hz.
 Women: Fo ranges from 200 to 300 Hz.
Voice Feminization: CTA
 The Cricothyroid Approximation surgery raises
 vocal pitch by stimulating cricothyroid muscle
 contraction through the approximation of the
 cricoid and thyroid.

 The surgery is performed in an inpatient
 setting under general anesthesia.
CTA Procedure
 The neck is prepared and
  draped in a sterile manner.

 I made a 1.5-2 cm
  transverse incision is made
  in an existing skin crease
  over the cricothyroid.
CTA Procedure
 The front of the voice box is
  removed thus making the
  voice box smaller. (This
  removes the projection of
  the Adam's apple at the
  same time.

 The vocal cords are then
  stretched and the front third
  to half of the cords are
  removed to shorten them.
CTA Procedure
 A thyrohyoid elevation may also be performed at the
  same time to try raising the voice box in the neck. This
  attempts to shorten the pharynx to feminize a portion of
  the resonance chamber (pharynx).

 A thyrohyoid elevation consists of passing sutures
  around the hyoid bone to hold the voice box in an
  elevated position in the neck.
Post surgery
• Hormonal treatment ( if any) are taken
  in the morning after surgery.

• Patient is subjected to a follow up check
  after seven days for suture removal.
Male to Female client
Before and After Surgery
            y


  Before         After
Before and After Surgery
  Before         After
Before and After Surgery
  Before         After
Voice change surgery-male to female or vice versa. Contact: yanhee_ent@yahoo.com

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Voice change surgery-male to female or vice versa. Contact: [email protected]

  • 1. Voice Feminization Surgery  Otorhinolaryngologist  Voice Change Surgeon (transgender)  Snoring Surgeon  Nose, Sinus Surgeon Ornouma Sriwanishvipat, MD.,ENT [email protected]
  • 2. Transgender/Transsexuals  It is a recognized disorder of gender identity in which people believed themselves to be born into the “wrong” gender body.  Most of them went to speech therapy; however, their effort is generally unsuccessful. Finally, they resolve to voice feminization surgery which is Cricothyroid Approximation (CTA).
  • 3. Pre-surgery  Stroboscope- is an instrument used to view the movement of your voice box and to record the sound of your voice.
  • 4. Voice Frequency  Fundamental frequency (Fo) is most evident voice quality. Cyclic movements that vocal folds perform per second expressed in hertz.  Men: Fo ranges from 100 to 150 Hz.  Women: Fo ranges from 200 to 300 Hz.
  • 5. Voice Feminization: CTA  The Cricothyroid Approximation surgery raises vocal pitch by stimulating cricothyroid muscle contraction through the approximation of the cricoid and thyroid.  The surgery is performed in an inpatient setting under general anesthesia.
  • 6. CTA Procedure  The neck is prepared and draped in a sterile manner.  I made a 1.5-2 cm transverse incision is made in an existing skin crease over the cricothyroid.
  • 7. CTA Procedure  The front of the voice box is removed thus making the voice box smaller. (This removes the projection of the Adam's apple at the same time.  The vocal cords are then stretched and the front third to half of the cords are removed to shorten them.
  • 8. CTA Procedure  A thyrohyoid elevation may also be performed at the same time to try raising the voice box in the neck. This attempts to shorten the pharynx to feminize a portion of the resonance chamber (pharynx).  A thyrohyoid elevation consists of passing sutures around the hyoid bone to hold the voice box in an elevated position in the neck.
  • 9. Post surgery • Hormonal treatment ( if any) are taken in the morning after surgery. • Patient is subjected to a follow up check after seven days for suture removal.
  • 10. Male to Female client
  • 11. Before and After Surgery y  Before  After
  • 12. Before and After Surgery  Before  After
  • 13. Before and After Surgery  Before  After