Surgical alteration of the vocal pitch.

TLDR

Surgical alteration of vocal pitch can be performed without distorting vocal quality, but intrachordal procedures must be conservative to avoid disrupting cord vibration. Pitch can be lowered by thyroplasty III (anteroposterior shortening of the thyroid ala) and raised by techniques such as cricothyroid approximation, A‑P expansion, cord incisions, steroid injection, or CO₂ laser ablation. Thyroplasty III dramatically lowered pitch in six patients and modestly in three with atrophic or scarred cords, while cricothyroid approximation raised pitch substantially in 11 patients, though its effect was reduced with thick cords.

Abstract

Vocal pitch can be changed surgically without distorting the vocal quality. It can effectively be lowered by thyroplasty III, that is anteroposterior shortening of the thyroid ala by vertical strip excision of the cartilage. The pitch lowering was dramatic in six, but fair in three where the vocal cords were atrophic or scarred. Vocal pitch can be elevated by various surgical techniques: 1) cricothyroid approximation, 2) A-P expansion of the thyroid ala, 3) longitudinal incisions in the cords, 4) intrachondral injection of the steroid, and 5) evaporation of the cords by CO2 laser. Cricothyroid approximation, performed on 11 patients, generally produced substantial rise in pitch, which was limited, however, when the cords were very thick. The intrachordal surgeries, 3-5, should be performed conservatively, because it may interfere with the vocal cord vibration.