Tracheal Shave and Anterior Commissure Detachment
Abstract submitted to Fall Voice Conference, San Antonio. Individuals undergoing tracheal shave (Adam’s apple reduction) are at risk for anterior commissure detachment — presenting as lower comfortable speaking pitch, reduced vocal range, loss of volume, increased effort. Visually: convex vocal cords (often misattributed to smoker’s polyps or reflux). Hoarseness >7–14 days = likely detachment, not edema. Repair: anterior laryngofissure with thyroid cartilage reconstruction; sutures placed through anterior commissure over external plate. Especially relevant for transgender patients desiring higher pitch post-tracheal shave.
Migration note: Relevant to Pitch Surgery and Feminization Laryngoplasty sections.