A thyroplasty is a surgical procedure to help or change a person’s voice. Different types of thyroplasty are available as treatments for several voice conditions or as part of gender affirming surgery.

A thyroplasty is a surgical procedure to change the position of a person’s vocal cords. A surgeon may perform this procedure to alter a person’s voice or ability to cough.

A person’s vocal cords are two bands of muscles with a specialized covering layer. They produce the sound of a person’s voice, and help them breathe and eat by preventing food from going down into the lungs.

The vocal cords sit inside their voice box, or larynx. A person’s larynx is in the middle of their neck. It allows them to make sounds and lets air flow into their lungs.

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Thyroplasty is a surgical operation on a person’s vocal cords. An otolaryngologist who specializes in conditions affecting the larynx will typically perform the procedure.

During a thyroplasty, an otolaryngologist surgically opens part of a person’s larynx. They then implant a device inside to move the position of the vocal cords.

A person might need different types of thyroplasty to treat medical conditions or as part of gender affirming surgery:

  • Type 1 (moving a vocal cord toward the middle of their larynx): Surgeons may use this type to treat unilateral vocal cord paralysis (UVCP) or injuries to the nerves in a person’s voice box. UVCP is a condition where one of a person’s vocal cords cannot move. They may have voice changes, shortness of breath, and difficulty swallowing.
  • Type 2 (moving a person’s vocal cords toward the side of their larynx): Type 2 thyroplasty is one treatment for spasmodic dysphonia. People with spasmodic dysphonia have voices that change and sound different.
  • Type 3 (shortening of a person’s vocal cords): Surgeons may use Type 3 thyroplasty to lower the pitch of a person’s voice. They may use it as part of gender affirmation surgery for trans men.
  • Type 4 (lengthening of a person’s vocal cords): Surgeons may use Type 4 thyroplasty to raise the pitch of a person’s voice. They may use it as part of gender affirmation surgery for trans women.

Laryngologists normally perform a thyroplasty in an operating room. To prepare a person for the procedure, healthcare professionals give them a local anesthetic with or without sedation. It may be necessary that a person be awake and vocal during the procedure to identify the best placement of the implant for voice control.

It is also advisable to avoid any irritants of the voice box prior to surgery. This can include smoking, alcohol, or caffeine. It is also helpful to inform family and friends that a person will not be able to speak well for a few days. A person can use a phone or pen and paper to communicate.

During a thyroplasty, the laryngologist makes a cut in the side of a person’s neck and into their larynx. They then implant a small device into the person’s voice box through this opening. This device changes the position or length of their vocal cords.

During the procedure, healthcare professionals give a person antibiotics and steroids. They also wake the person and ask them to speak. This allows the laryngologist to adjust the effect on a person’s voice box.

A thyroplasty normally lasts about 1 hour.

After a thyroplasty, a person typically stays in the hospital for one night for observation. This is to make sure they can breathe correctly. They will normally:

  • wake up with a bandage the next day, which they should not move
  • be able to:
    • get out of bed after surgery to use the bathroom
    • eat their typical diet

They should not use their voice for up to 3 days after surgery, including the day of their surgery. This includes:

  • not:
    • talking
    • whispering
    • laughing
  • avoiding coughing if possible

After 3 days, a person can use their voice moderately, without:

  • excessive talking
  • yelling
  • cellphone use

After a week, they can use their voice normally. They should avoid exerting themselves for 2 weeks after surgery and avoid any strenuous activities.

They should seek emergency medical attention if they have shortness of breath or difficulty breathing, bleeding, or a fever.

Healthcare professionals will schedule a follow-up check-in 1 week after surgery.

Some types of thyroplasty may be necessary to help treat certain medical conditions. For example, one type of thyroplasty can help treat vocal cord paralysis. This improves how well a person can:

  • speak
  • swallow
  • cough

Other thyroplasty types change a person’s voice, which may be part of their gender affirmation surgery. Having an authentic gender affirming vocal presentation can be an essential part of the transitioning process for many transgender people.

One common risk of thyroplasty is having a sore neck after surgery. A person may have numb skin on their neck. This usually returns to normal within a few months, but it can be permanent.

Research published in 2020 showed between 7% and 20% of thyroplasty operations involve complications. However, only 5.6% of those complications were major, with no long-term effects. Complications included:

  • hematoma, blood pooling under a person’s skin
  • hemorrhage, loss of blood
  • prosthesis extrusion, where a person’s implant moves
  • laryngeal edema, swelling, and fluid in a person’s larynx
  • aspiration pneumonia, a lung infection when a person breathes food or liquid into their lungs

Thyroplasty is a surgical operation that may help treat medical conditions affecting a person’s voice and ability to cough. Some types of thyroplasty alter the pitch of a person’s voice, which may form part of gender affirming surgery.

During a thyroplasty, healthcare professionals put a person to sleep with an anesthetic. A laryngologist then makes a cut into their voice box and inserts an implant. This implant moves the person’s vocal cords and changes their voice.

People normally stay in a hospital for one night afterward. They should not use their voice for 3 days, followed by resting their voice for a week. They should also avoid exerting themselves for 2 weeks.

Major complications are uncommon. If a person does experience complications, they should get emergency medical attention.