The technique of voice feminisation has gone through different phases. Initially, a technique was performed externally, through the neck, called the cricothyroid approach, known as CTA. In this technique, the vocal cords are not touched. Later, or rather, simultaneously, a technique was developed in which the vocal cords are touched, known as glottoplasty, first Wendler’s glottoplasty and, more recently, Kim’s glottoplasty in South Korea. These techniques, in which the vocal cords are touched, have better results than the cricothyroid approach …
So that nowadays, in cases where an autoplasty cannot be performed due to an anatomical problem, the external technique, the cricothyroid approach, is used.
But without a doubt, the most widely used techniques in the world today are endoscopic techniques, glottoplasty; they are laborious techniques, technically difficult to perform, because they work on a surface of approximately 2 cm, which is the size of the vocal cords, and there we have to produce a scar of approximately 3 mm.
At the beginning, these techniques took four or five hours and, nowadays, due to the improvement of the technique, as well as the learning curve, it takes approximately 90 minutes and we can schedule 2-3 interventions in the same surgical session.
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