This study was performed at the University of California, San Diego Medical Centers.
Laser-Assisted Voice Adjustment (LAVA) in Transsexuals†
Article first published online: 2 JAN 2009
Copyright © 2006 The Triological Society
Volume 116, Issue 4, pages 655–660, April 2006
How to Cite
Orloff, L. A., Mann, A. P., Damrose, J. F. and Goldman, S. N. (2006), Laser-Assisted Voice Adjustment (LAVA) in Transsexuals. The Laryngoscope, 116: 655–660. doi: 10.1097/01.mlg.0000205198.65797.59
This paper was originally presented in a preliminary form at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery Foundation on September 29, 1999, in New Orleans, Louisiana, U.S.A.
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 4 JAN 2006
- Pitch-raising surgery;
- male-to-female transsexual;
- vocal fold vaporization;
Objective: The objective of this study was to evaluate results of laser-assisted voice adjustment (LAVA) surgery in male-to-female (MTF) transsexual patients with androphonia.
Methods: The authors conducted a prospective case–control study of MTFs who underwent CO2 laser vocal fold vaporization between 1997 and 2003. Thirty-one patients were self-referred for voice feminization. Pre- and postoperative evaluations were completed. Patients' voices were recorded to obtain Fo before and after surgery. Voice Handicap Index (VHI) questionnaires were completed by post-LAVA patients. A panel of blinded listeners identified patients as male or female based on samples of connected speech recorded over the telephone.
Results: Mean follow-up (23 weeks) revealed pitch increases averaging 26 Hz. Self-evaluations revealed increases in voice femininity, congruity with self-image, and satisfaction. However, the evaluations also showed decreased vocal quality, loudness, and vocal range. Mean VHI was consistent with VHI scores associated with Reinke's edema. Six of 10 patients were consistently perceived as female.
Conclusion: LAVA provides a conservative treatment for androphonia. Postoperative voice therapy may optimize outcomes.