Background: Feminization laryngochondroplasty (FLC) methods have evolved from using a midcervical incision to a submental, less visible incision. The scar may be unacceptable to the patient because it signals gender reassignment surgery. An endoscopic transoral approach to FLC inspired by transoral endoscopic thyroidectomy was recently suggested to avoid the neck scar; however, it requires special equipment and has a long learning curve. A vestibular incision is used to approach the chin in lower-third facial feminization surgery. The authors propose that this incision may be extended to the thyroid cartilage in performing direct FLCs. The authors describe their experience with a novel, minimally invasive, direct transvestibular use of the chin-reshaping incision.
Methods: The medical records of all patients who underwent direct transvestibular FLC (DTV-FLC) from December of 2019 to September of 2021 were retrieved and reviewed for this retrospective cohort study. Data on the operative, postoperative, and follow-up courses, complications, and functional and cosmetic results were retrieved.
Results: Nine transgender women were included. Seven DTV-FLCs were performed during lower-third facial feminization surgery, and two were isolated DTV-FLCs. One was a revision DTV-FLC. Transient minor complications were encountered and resolved by the postoperative visit at 1 to 2 months. Vocal fold function and voice quality remained intact. Eight available patients were satisfied with the surgical results. A blinded assessment by eight plastic surgeons determined that seven procedures were successful.
Conclusion: The novel DTV-FTLC approach either in isolation or as part of lower-third facial feminization surgery facilitated scar-free FLC with satisfactory cosmetic and functional results.
Clinical Question/level Of Evidence: Therapeutic, IV.
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Outcome of isolated and combined direct feminization laryngochondroplasty: Our first 20 cases.
J Craniomaxillofac Surg
November 2024
Departments of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Article Synopsis
- This study examines the surgical outcomes of the first 20 transgender women who underwent feminization thyroid laryngochondroplasty (FLC) using a direct transvestibular approach between December 2019 and October 2023.
- It highlights that all surgeries were feasible with minor complications that resolved naturally, and 18 out of 20 patients reported cosmetic improvements after the procedure.
- Overall, the findings suggest that the direct transvestibular FLC method is effective, leading to high patient satisfaction and positive aesthetic results.
Direct Transvestibular Feminization Thyroid Laryngochondroplasty.
Plast Reconstr Surg
February 2024
From the Departments of Otolaryngology, Head and Neck Surgery, and Maxillofacial Surgery.
Background: Feminization laryngochondroplasty (FLC) methods have evolved from using a midcervical incision to a submental, less visible incision. The scar may be unacceptable to the patient because it signals gender reassignment surgery. An endoscopic transoral approach to FLC inspired by transoral endoscopic thyroidectomy was recently suggested to avoid the neck scar; however, it requires special equipment and has a long learning curve.
View Article and Find Full Text PDFTransvestibular urethrolysis.
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December 2011
Luciano Giuliani Department of Urology, University of Genoa, Genoa, Italy.
Objectives: Bladder outlet obstruction with obstructive and irritative urinary symptoms may be a complication of surgery for female urinary incontinence. In presence of persistent symptoms the therapy is surgical and usually consists in an accurate urethrolysis. The way of approach is generally transvaginal.
View Article and Find Full Text PDF[Transvestibular urethrolysis].
Actas Urol Esp
June 2012
Department of Urology, Clinica Urologica L. Giuliani, University of Genova, Génova, Italia.
Objective: Bladder outlet obstruction with obstructive and irritative urinary symptoms may be a complication of surgery for female urinary incontinence. In presence of persistent symptoms, the therapy is surgical and usually consists in an accurate urethrolysis. The way of approach is generally transvaginal.
View Article and Find Full Text PDFEndoscopic transvestibular paramandibular exploration of the infratemporal fossa and parapharyngeal space: a minimally invasive approach to the middle cranial base.
Laryngoscope
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Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Objectives/hypothesis: To describe a novel transvestibular endoscopic approach for the exposure, exploration, and resection of lesions in the infratemporal fossa (ITF) and parapharyngeal space (PPS).
Study Design: Surgical technique and clinical feasibilty of a novel approach to the middle cranial base.
Methods: The transvestibular endoscopic approach was applied to four patients with lesions involving the ITF and PPS.
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