{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:22:27Z","timestamp":1790029347743,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Voice feminizing surgery is frequently needed for transgender female patients. Among several surgical options, Wendler glottoplasty (WG) and laser reduction glottoplasty (LRG) are two endoscopic procedures. However, because a single procedure may not produce sufficient benefit, the two surgeries may sometimes be sequentially performed. This study was carried out to present the voice results of such sequential surgeries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is an individual retrospective cohort study, performed at a tertiary referral center, that is a university hospital. 18 transgender patients were treated with WG initially and then underwent LRG; 17 had LRG first then WG. All 35 cases were performed during a 15\u2010year period and followed for at least 1\u2009year postoperatively. Voice Handicap Index (VHI\u201030), transsexual voice questionnaire (TVQ), and acoustic analysis with \/a\/ and running speech were obtained pre\u2010 and postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VHI and TVQ improved significantly postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Their preoperative, first, and second postoperative mean sF0 were 146, 175, and 215\u2009Hz, respectively; these differences were statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Their postoperative mean jitter percent, shimmer percent, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), and cepstral spectral index of dysphonia (CSID) worsened significantly compared to preop values (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05); however, mean postoperative acoustic results were still within normal limits. Patients' self\u2010ratings of their postsurgery voices revealed all feminine, leading to a patient gratification score of 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>If transgender female patients are unsatisfied with their voice after WG or LRG, the addition of the alternative procedure may significantly feminize their voice. Sequential WG and LRG is a successful surgical option for voice feminization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:1133\u20131138, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30958","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T12:36:26Z","timestamp":1691584586000},"page":"1133-1138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Sequential Wendler Glottoplasty and Laser Reduction Glottoplasty for Voice Feminization"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8999-3237","authenticated-orcid":false,"given":"Taner","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Hacettepe University Faculty of Medicine  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1044\/2015_AJSLP-14-0098"},{"issue":"5","key":"e_1_2_6_3_1","first-page":"335","article-title":"Surgical alteration of the vocal pitch","volume":"12","author":"Isshiki N","year":"1983","journal-title":"J Otolaryngol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2890040512"},{"key":"e_1_2_6_5_1","volume-title":"Proceedings of the Union of the European Phoniatricians; Salsomaggiore, Italy","author":"Wendler J","year":"1990"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(99)80028-9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2009.07.004"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.04.004"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.03.006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29050"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2009.06.004"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489421993728"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1044\/1058-0360.0603.66"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2012.11.005"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2012.06.001"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2058-8"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23467"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.04.007"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016487409126379"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2511-3"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940010901116"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.05.002"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000205198.65797.59"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-015-3721-7"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.07.018"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26110"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26127"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28764"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30958","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T12:36:57Z","timestamp":1708087017000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,9]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/lary.30958"],"URL":"https:\/\/doi.org\/10.1002\/lary.30958","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,9]]},"assertion":[{"value":"2023-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}