(0819) Incidence of False Vocal Fold Hemorrhage and Voice Changes After Chondrolaryngoplasty for Gender Affirmation

Introduction: Chondrolaryngoplasty, also known as a tracheal shave, is becoming a more common procedure for gender affirmation. With growing demand, it is necessary to better understand the risk of postoperative complications such as intralaryngeal bleeding and its association with voice change. This study is designed to assess incidence of and relationship of these risks.

Methods: A retrospective review of 51 patients who underwent chondrolaryngoplasty was conducted. Of these, 32 patients had completed pre and postop laryngoscopy and voice handicap index 10 (VHI-10) scores. Findings on laryngoscopy and VHI-10 scores were analyzed for changes after surgery, including false vocal fold hemorrhage, and anterior commissure detachment.

Results: Of the total, 37% of patients had false vocal fold (FVF) hemorrhage. There was little change in patient-reported voice outcomes after surgery, with a mean change in VHI-10 after surgery of +0.5 (SE 0.85), which was nonsignificant (p = 0.56). There was no statistically significant correlation was found between VHI-10 score change and the presence of hemorrhage (p = 0.06), and all hemorrhages resolved without intervention. The anterior commissure was detached in no cases.

Conclusions: FVF hemorrhage is a risk of chondrolaryngoplasty that is not uncommon, but it does not appear to affect voice significantly or require intervention. Further studies on complications and outcomes after gender affirming laryngeal surgery is critical for optimal care of transgender and nonbinary individuals.