Pitch-lowering

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Information for patients considering a surgery to lower their pitch.

The following is meant for my patients and is based on my experience. There certainly are regional and individual surgeon variations in style.

Definition

Surgery to lower the pitch of the voice may also be called a thyroplasty. One mechanism for accomplishing a lower comfortable speaking pitch is to loosen the tension on the vocal cords.

Indications

There are times when a desire is present to have a lower speaking pitch and it cannot be adequately accomplished with training.

Alternatives

With practice, some people have been able to lower their speaking pitch. While I wouldn't recommend it, even cigarette smoking creates edema (swelling) in the vocal cords and lowers the pitch.

Presurgery

Before the surgery/procedure, a PARQ conference is held with you. This is an acronym for Procedures, Alternatives, Risks and Questions. It means that your surgeon has discussed with you in full detail the reasons for the procedure, the alternative treatments to the procedure, the risks of the procedure and that you have been given ample time to ask questions and are satisfied with those reasons and answers. In addition, an evaluation and examination of your voice box is essential. This involves a skilled examiner listening to and measuring a number of characteristics of your voice. A visual inspection of your voice box is also performed. This takes about an hour.

Risks

The general risks of surgery are discussed here. There are some specific risks which may include not getting exactly the pitch you want (lowering it too much or not enough). There may also be some reduction in overall vocal range.

Procedure

The surgery is performed in an outpatient setting under general anesthesia. After you are asleep, a one to two inch incision is placed parallel to, or in a skin crease of your neck over the Adam’s apple. A strip of cartilage is removed from one or both sides of the voice box and the new edges sutured together.

Recovery

Your voice will likely be changed immediately, though the final pitch may not be settled for several months. Initially there may be some swelling that makes the voice quite low and this changes as the swelling goes down.

Instructions during healing

Relative voice rest is helpful for one week after the procedure. Aerobic activity may be resumed after two weeks. No weight lifting for one month. There will be a single suture in the skin to be removed one week after surgery.

Benefits

Lowered day-to-day speaking pitch.