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Feminization laryngoplasty is considered a less effective method for voice feminization compared to voice therapy.
Answer: False
Explanation: While voice therapy is often the initial approach, feminization laryngoplasty serves as a surgical alternative offering permanent vocal modification when therapy yields unsatisfactory results.
Voice therapy is always the first recommended approach for individuals seeking vocal alterations for gender affirmation.
Answer: True
Explanation: Voice therapy is typically the initial recommended approach for individuals seeking vocal alterations for gender affirmation, aiming to achieve desired vocal changes through non-surgical means.
It is estimated that around 50% of transgender women opt for surgical voice feminization methods.
Answer: False
Explanation: Estimates suggest that only about 1% of transgender women opt for surgical voice feminization, with a larger proportion utilizing non-surgical methods like voice therapy.
The focus of gender affirmation surgery has historically remained solely on genital conformation.
Answer: False
Explanation: While historically focused on genital conformation, gender affirmation surgery has evolved to encompass secondary sex characteristics, including voice feminization.
There has been a decreasing trend emphasizing social recognition over sexual recognition in gender affirmation surgery.
Answer: False
Explanation: There has been an increasing trend emphasizing social recognition in gender affirmation, reflecting a broader understanding of gender identity beyond solely sexual characteristics.
What is the primary goal of feminization laryngoplasty (FL)?
Answer: To reduce the size of the larynx to achieve a higher, more feminine vocal pitch.
Explanation: The primary objective of feminization laryngoplasty is to increase the fundamental frequency of the voice by reducing the size of the larynx, thereby achieving a higher, more feminine vocal pitch.
Which of the following is an alternative name or abbreviation for feminization laryngoplasty mentioned in the source?
Answer: FL or FemLar
Explanation: Feminization laryngoplasty is commonly referred to by the abbreviations FL or FemLar.
Feminization laryngoplasty falls under which medical specialty?
Answer: Laryngology
Explanation: Feminization laryngoplasty is a surgical procedure within the domain of Laryngology, the medical specialty focused on the larynx and voice disorders.
How does feminization laryngoplasty compare to voice therapy for voice feminization?
Answer: It is a surgical alternative used when voice therapy yields unsatisfactory results.
Explanation: Voice therapy is typically the initial recommendation; feminization laryngoplasty serves as a surgical alternative for individuals whose vocal goals are not met through non-surgical means.
Feminization laryngoplasty is also known by the abbreviation FemLar.
Answer: True
Explanation: Feminization laryngoplasty is commonly referred to by the abbreviation FemLar, alongside FL.
The medical specialty primarily associated with feminization laryngoplasty is Cardiology.
Answer: False
Explanation: Feminization laryngoplasty falls under the medical specialty of Laryngology, which deals with disorders of the larynx and voice.
Feminization laryngoplasty is currently one of the most popular and widely known voice feminization surgeries globally.
Answer: False
Explanation: Feminization laryngoplasty is less popular and less widely known compared to other voice feminization surgical options and is performed by a limited number of surgeons.
Transgender surgery began gaining significant attention in the late 1960s, following the work of surgeons like Dr. James P. Thomas.
Answer: False
Explanation: Transgender surgery began gaining significant attention in the early 1950s, notably following the public profile of Christine Jorgensen.
Cricothyroid approximation (CTA) was the first surgical procedure developed for voice feminization based on the cricothyroid distance principle.
Answer: True
Explanation: Cricothyroid approximation (CTA) was indeed the initial surgical procedure developed for voice feminization, predicated on the principle of altering the distance between the thyroid and cricoid cartilages.
A significant drawback of the cricothyroid approximation (CTA) procedure is that it often results in a natural-sounding, resonant voice.
Answer: False
Explanation: A significant drawback of the cricothyroid approximation (CTA) procedure is that it frequently results in an unnatural falsetto quality, rather than a natural-sounding voice.
Wendler Glottoplasty and laser tuning methods are examples of traditional surgical techniques for voice feminization.
Answer: True
Explanation: Wendler Glottoplasty and various laser tuning techniques represent established, traditional surgical methods employed for voice feminization.
Glottoplasty and laser tuning techniques avoid the unnatural falsetto quality sometimes seen with CTA.
Answer: True
Explanation: Glottoplasty and laser tuning techniques are advantageous as they typically avoid the unnatural falsetto quality that can be a consequence of the Cricothyroid Approximation (CTA) procedure.
The conceptual basis for feminization laryngoplasty is attributed to Dr. James P. Thomas.
Answer: False
Explanation: While Dr. James P. Thomas performed the first feminization laryngoplasty surgery in 2003, the conceptual underpinnings of surgical voice feminization, including principles related to cricothyroid distance, were explored by others prior to his work. The modern open laryngoplasty technique was inspired by Somyos Kunachak.
The first feminization laryngoplasty surgery was performed in 2003 by Dr. James P. Thomas.
Answer: True
Explanation: The inaugural feminization laryngoplasty surgery was conducted in 2003 by Dr. James P. Thomas.
What was a significant drawback of the early Cricothyroid Approximation (CTA) surgical technique for voice feminization?
Answer: It often resulted in an unnaturally high falsetto voice quality.
Explanation: A significant drawback of the Cricothyroid Approximation (CTA) procedure is that the resulting voice often possesses an unnatural falsetto quality, which can be unsatisfactory for patients.
Which of the following is NOT considered a traditional surgical technique for voice feminization mentioned in the source?
Answer: Feminization Laryngoplasty (FL)
Explanation: Feminization Laryngoplasty (FL) represents a more contemporary surgical approach, whereas Wendler Glottoplasty, Laser Reduction Glottoplasty (LRG), and Vocal Fold Muscle Reduction (VFMR) are considered traditional techniques.
Who performed the first feminization laryngoplasty surgery, and approximately when?
Answer: James P. Thomas in 2003.
Explanation: The first feminization laryngoplasty surgery was performed by James P. Thomas in 2003.
Testosterone during puberty causes the larynx to decrease in size and vocal folds to thin.
Answer: False
Explanation: During puberty, testosterone causes the larynx to increase in size and the vocal folds to thicken and lengthen, leading to a deeper voice.
Voice changes induced by testosterone during puberty can be reversed with feminizing hormone therapy.
Answer: False
Explanation: The voice changes induced by testosterone during puberty, such as laryngeal enlargement, are generally irreversible even with feminizing hormone therapy.
Kazutomo Kitajima and colleagues discovered a direct linear relationship between vocal pitch and the distance between the thyroid and cricoid cartilage.
Answer: False
Explanation: Kazutomo Kitajima and colleagues discovered an *inverse* linear relationship between vocal pitch and the distance between the thyroid and cricoid cartilage.
The voice changes caused by testosterone during puberty, such as larynx enlargement, are:
Answer: Generally irreversible, even with feminizing hormone therapy.
Explanation: The voice changes induced by testosterone during puberty, such as laryngeal enlargement and vocal fold thickening, are generally irreversible and persist even with feminizing hormone therapy.
The principle discovered by Kitajima and colleagues related vocal pitch to the distance between the thyroid and cricoid cartilages. This relationship was described as:
Answer: An inverse linear relationship.
Explanation: Kitajima and colleagues identified an inverse linear relationship between vocal pitch and the distance between the thyroid and cricoid cartilages, indicating that a shorter distance correlates with higher pitch.
Thyrohyoid elevation is the first main surgical step in feminization laryngoplasty.
Answer: False
Explanation: The primary surgical steps typically involve an initial incision and vocal fold modification, followed by thyrohyoid elevation.
Feminization laryngoplasty can be performed concurrently with thyroid chondroplasty to reduce the Adam's apple.
Answer: True
Explanation: Feminization laryngoplasty can be effectively combined with thyroid chondroplasty in a single surgical session to address the prominence of the Adam's apple.
A horizontal incision, approximately 5 cm long, is made along a skin crease located above the thyroid notch during feminization laryngoplasty.
Answer: True
Explanation: The surgical approach for feminization laryngoplasty typically involves a horizontal incision, approximately 5 cm in length, strategically placed along a natural skin crease superior to the thyroid notch to minimize scar visibility.
Removing a strip of the anterior thyroid cartilage helps to increase the diameter of the laryngeal opening.
Answer: False
Explanation: Removing a strip of the anterior thyroid cartilage serves to reduce the contour of the Adam's apple and decrease the laryngeal diameter, not increase it.
About a quarter of the posterior false vocal folds is removed during feminization laryngoplasty to improve vocal fold visibility.
Answer: False
Explanation: Approximately a quarter of the *anterior* false vocal folds are removed, not the posterior, to reduce the upper laryngeal diameter and enhance visualization of the true vocal folds.
Up to 50% of the posterior vocal folds may be removed to raise the patient's speaking pitch.
Answer: False
Explanation: The procedure involves modification of the *anterior* vocal folds, with up to 50% of the anterior portion potentially removed, not the posterior vocal folds.
During thyrohyoid elevation, the cricoid cartilage is moved higher in the neck.
Answer: False
Explanation: Thyrohyoid elevation involves repositioning the thyroid cartilage superiorly relative to the cricoid cartilage, effectively raising the larynx, not moving the cricoid cartilage itself higher.
Sutures and screws are used to fix the larynx in a higher position after thyrohyoid elevation.
Answer: True
Explanation: Following thyrohyoid elevation, sutures and screws are employed to secure the larynx in its elevated position, ensuring stability while preserving essential functional movement.
What are the two main surgical stages of feminization laryngoplasty, in order?
Answer: Incision and vocal fold modification, followed by thyrohyoid elevation.
Explanation: The feminization laryngoplasty procedure is typically executed in two primary stages: first, the incision and modification of the vocal folds, followed by the thyrohyoid elevation.
What is the purpose of removing a strip of the anterior thyroid cartilage during feminization laryngoplasty?
Answer: To reduce the contour of the Adam's apple and decrease laryngeal diameter.
Explanation: Removing a strip of the anterior thyroid cartilage during feminization laryngoplasty serves to reduce the prominence of the Adam's apple and decrease the overall diameter of the larynx.
Which of the following describes the incision made during feminization laryngoplasty?
Answer: A horizontal incision approximately 5 cm long, above the thyroid notch.
Explanation: The surgical approach for feminization laryngoplasty typically involves a horizontal incision, approximately 5 cm in length, strategically placed along a natural skin crease superior to the thyroid notch to minimize scar visibility.
Transgender women constitute the majority of patients seeking feminization laryngoplasty.
Answer: True
Explanation: Transgender women constitute the majority of patients, but the procedure is also sought by nonbinary individuals and cisgender women desiring a higher vocal pitch or more feminine vocal characteristics.
Nonbinary individuals seeking feminization laryngoplasty typically have the same vocal goals as transgender women.
Answer: False
Explanation: Nonbinary individuals may have distinct vocal goals, potentially seeking an androgynous voice rather than strictly feminine, necessitating individualized care.
Who are the primary candidates for feminization laryngoplasty?
Answer: Primarily transgender women, nonbinary individuals, and cisgender women with deep voices.
Explanation: The primary candidates for feminization laryngoplasty include transgender women, nonbinary individuals, and cisgender women who desire a higher vocal pitch or more feminine vocal characteristics.
What unique consideration is mentioned for nonbinary individuals seeking feminization laryngoplasty?
Answer: They may seek an androgynous voice rather than strictly feminine.
Explanation: A unique consideration for nonbinary individuals is their potential desire for an androgynous voice, which may differ from the strictly feminine vocal goals of some transgender women, underscoring the need for personalized surgical planning.
Feminization laryngoplasty aims to decrease the pitch of a patient's voice.
Answer: False
Explanation: Feminization laryngoplasty is designed to increase the fundamental frequency of the voice, resulting in a higher, more feminine pitch, not to decrease it.
A potential risk of feminization laryngoplasty includes the development of granuloma in the vocal cords.
Answer: True
Explanation: The development of granuloma in the vocal cords is recognized as a potential complication following feminization laryngoplasty surgery.
Patients undergoing feminization laryngoplasty are advised to avoid voice rest completely for the first month post-surgery.
Answer: False
Explanation: Post-operative management typically includes a period of voice rest, usually for at least two weeks, to facilitate healing and prevent complications.
Feminization laryngoplasty typically results in a pitch change of less than 3 semitones.
Answer: False
Explanation: Feminization laryngoplasty typically achieves a pitch change of approximately 6 semitones (20-80 Hz), which is significantly more than 3 semitones.
Besides pitch, feminization laryngoplasty can also reduce vocal weight and alter resonance quality.
Answer: True
Explanation: In addition to increasing vocal pitch, feminization laryngoplasty can also reduce vocal weight and modify the resonance characteristics of the voice.
Feminization laryngoplasty can reduce the prominence of the Adam's apple, but less effectively than a standard tracheal shave.
Answer: False
Explanation: Feminization laryngoplasty, particularly when combined with thyroid chondroplasty, can effectively reduce the prominence of the Adam's apple, often more so than a standard tracheal shave which may preserve more cartilage.
A key advantage of feminization laryngoplasty is that it preserves the function of the cricothyroid muscle, allowing for falsetto range use.
Answer: True
Explanation: A significant advantage of feminization laryngoplasty is its preservation of cricothyroid muscle function, which enables patients to retain the ability to utilize their falsetto range.
Post-surgery, patients are typically prescribed only acetaminophen for pain relief.
Answer: False
Explanation: Post-operative pain management typically involves a combination of acetaminophen and narcotic analgesics, rather than acetaminophen alone.
Feminization laryngoplasty is generally considered highly suitable for professional vocal performers like singers due to its preservation of vocal range.
Answer: False
Explanation: While feminization laryngoplasty preserves some vocal range, potential reductions in voice volume and pitch continuity may make it less suitable for professional vocal performers compared to other specialized techniques.
Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) is recommended for singers as it better preserves singing ability.
Answer: True
Explanation: Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) is often recommended for singers because it is considered to better preserve vocal function for singing.
Granuloma of the vocal cords, if it occurs, always requires surgical removal.
Answer: False
Explanation: Granulomas of the vocal cords, while a potential complication, do not always necessitate surgical removal and may resolve spontaneously or be managed through manual removal.
Dysphonia, or hoarseness, is a common symptom that typically resolves within the first month after surgery.
Answer: False
Explanation: Dysphonia is a common post-operative symptom, but it typically resolves gradually over the first two months, rather than strictly within the first month.
Further treatment like laser therapy or revision surgery is only considered if the patient experiences persistent hoarseness beyond six months.
Answer: False
Explanation: Further interventions such as laser therapy or revision surgery may be considered if hoarseness persists significantly or if asymmetrical healing occurs, not strictly limited to a six-month timeframe.
Severe swelling after surgery can obstruct breathing and may necessitate a tracheostomy.
Answer: True
Explanation: Severe post-operative swelling, though rare, can potentially lead to airway obstruction, necessitating interventions such as a tracheostomy.
Patients typically require an overnight hospital stay after feminization laryngoplasty for observation.
Answer: False
Explanation: Feminization laryngoplasty is often performed as an outpatient procedure, with most patients discharged on the same day, unless specific complications warrant an extended stay.
Patients can undergo surgeries requiring intubation immediately after feminization laryngoplasty.
Answer: False
Explanation: It is generally advised to avoid surgeries requiring intubation for at least three months post-feminization laryngoplasty to allow for adequate healing and minimize risks.
Post-operative vocal therapy is recommended to help patients adapt to their new voice and refine communication aspects.
Answer: True
Explanation: Post-operative vocal therapy is crucial for helping patients adapt to their altered voice, optimizing its use, and refining communication skills, rather than reversing surgical outcomes or accelerating healing.
Revision surgery is generally recommended for patients who have had prior voice surgery before feminization laryngoplasty.
Answer: False
Explanation: Revision surgery is typically not recommended for patients with a history of prior voice surgery, as it can complicate the surgical field and outcomes.
Which of the following is NOT listed as a potential risk or complication of feminization laryngoplasty?
Answer: Permanent loss of the ability to whisper.
Explanation: While granuloma, severe swelling, and dysphonia are recognized potential risks or complications of feminization laryngoplasty, permanent loss of the ability to whisper is not typically listed as a direct complication.
What is the average pitch change typically achieved with feminization laryngoplasty?
Answer: Approximately 6 semitones (20-80 Hz).
Explanation: Feminization laryngoplasty typically results in an average pitch increase of approximately 6 semitones, corresponding to a change of 20-80 Hz in the fundamental frequency.
Besides increasing pitch, what other vocal qualities can feminization laryngoplasty affect?
Answer: Vocal weight and resonance quality.
Explanation: Beyond increasing pitch, feminization laryngoplasty can also modify vocal weight and alter the resonance quality of the voice.
How does the effect of feminization laryngoplasty on the Adam's apple compare to a standard tracheal shave?
Answer: Feminization laryngoplasty can reduce the Adam's apple more effectively, as it involves removing tissue typically preserved in a tracheal shave.
Explanation: Feminization laryngoplasty, particularly when combined with thyroid chondroplasty, can reduce the Adam's apple more effectively than a standard tracheal shave, as it involves the removal of cartilage tissue typically preserved in a tracheal shave.
What is a key advantage of feminization laryngoplasty (FL) compared to some earlier surgical methods?
Answer: It preserves cricothyroid muscle function, allowing use of the falsetto range.
Explanation: A key advantage of feminization laryngoplasty is its preservation of cricothyroid muscle function, which enables patients to retain the ability to utilize their falsetto range.
What is a potential negative effect of feminization laryngoplasty that might make it less suitable for professional vocal performers?
Answer: A potential drop in voice volume and decreased pitch continuity.
Explanation: A potential negative effect of feminization laryngoplasty is a reduction in voice volume and decreased pitch continuity, which may render it less suitable for professional vocal performers.
Which surgical procedure is often recommended for professional singers seeking voice feminization because it better preserves singing ability?
Answer: Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC).
Explanation: For professional singers, Vocal Fold Shortening and Retrodisplacement of the Anterior Commissure (VFSRAC) is often recommended as it is considered to better preserve vocal function for singing.
How is granuloma of the vocal cords typically managed post-surgery?
Answer: It typically resolves on its own or may require manual removal.
Explanation: Granuloma of the vocal cords is typically managed conservatively, often resolving spontaneously or through manual removal, rather than always requiring surgical intervention or being a standard part of healing.
Dysphonia (hoarseness) experienced after feminization laryngoplasty typically:
Answer: Gradually resolves over time, often within the first two months.
Explanation: Dysphonia is a common post-operative symptom that generally resolves gradually over the first two months following feminization laryngoplasty.
Under what circumstances might further treatment (like laser therapy or revision surgery) be considered after feminization laryngoplasty?
Answer: If hoarseness persists significantly or vocal cords heal with asymmetrical tension.
Explanation: Further treatment options like laser therapy or revision surgery are typically considered for persistent, significant hoarseness or if the vocal cords exhibit asymmetrical healing, rather than for minor issues or non-compliance.
What is the recommended duration for complete voice rest after feminization laryngoplasty?
Answer: At least 2 weeks.
Explanation: Complete voice rest is generally recommended for at least two weeks following feminization laryngoplasty to allow for initial healing and scar tissue formation.
Post-operative vocal therapy for feminization laryngoplasty primarily aims to:
Answer: Help patients adapt to their new voice and refine communication skills.
Explanation: Post-operative vocal therapy is crucial for helping patients adapt to their altered voice, optimizing its use, and refining communication skills, rather than reversing surgical outcomes or accelerating healing.
Revision surgery after feminization laryngoplasty is generally NOT recommended if the patient:
Answer: Has a history of prior voice surgery.
Explanation: A history of prior voice surgery is generally considered a contraindication for revision surgery following feminization laryngoplasty, as it can introduce complexities and potential risks.
What is the recommended timeframe to avoid surgeries requiring intubation after feminization laryngoplasty?
Answer: 3 months
Explanation: It is generally advised to avoid surgeries requiring intubation for at least three months following feminization laryngoplasty to allow for adequate healing and minimize risks.