Voice change

Yanhee International HospitalBangkok, Thailand

Dr. Ornouma Sriwanishvipat, MD. ENT

Voice Change Surgeon

The remarkable surgeon The doctor that you can count on!

Otorhinolaryngologist Voice Change Surgeon

(transgender) Snoring, Nose, Sinus

Surgeon

Meet Our Remarkable Voice SpecialistDr. Ornouma Sriwanishvipat has been

reporting successful remarkable ratio of cures for Snoring, Deviated septum, Sinus, Throat, Ear, and nose surgeries, and pillar procedure for years as well as an enormous number of successful transgender voice change.

In fact, she has served patients from around the globe.

Voice disorders? Voice change?She has all the answers to your needs and

always available to serve you.

Surgeries/Procedures performedVoice Change Surgery..... >300 casesSnoring………………………>400 casesTonsillectomy………………> 200 casesCorrect Hoarseness……...>200 casesSeptoplasty…………..….... >300 casesSinus Surgery……………….>30 casesMyringoplasty………….……>80 casesTympanostomy tube……….>100 cases

LocationAddress: 454 Charansanitwong Road, Bang-O,

Bangplad, Bangkok 10700 Thailand

WEBSITE: www.dr-ornouma.com

Email: [email protected]

Change your voice change

your life

Voice feminization/masculizationmale to female/female to

male The voice is an important

determinant factor that reveals whether an individual is MALE or FEMALE.

Voice Feminization The term voice feminization is

used to describe what the desired outcome of surgical techniques, speech therapy, and self-help programs. The methods used for voice feminization vary from professional techniques used for vocal training, speech therapy by trained speech pathologists and several pitch altering surgeries

Goal: 1. To assist the male-to-female transsexual to achieve congruency between their gender identity and their presentation in the female role.

2. To change a perceived male sounding voice to a perceived female sounding voice.

3. To satisfy your desired voice.

Things that help make a voice feminine

Pitch - Feminine voices are higher; this may be the most important concern.

Pitch Range- Men tend to be more monotone, varying the pitch helps feminize the voice.

Speech Rate - Men typically speak at a steady rate, while women tend to speak in shorter bursts followed by pauses.

Language patterns - The language that women use differs from that of men, although the degree of variation can be quite different from one language to the next

While hormone replacement therapy and gender reassignment surgery can cause a more feminine outward appearance, they do little to alter the pitch or sound of the voice. The existing vocal structure can be surgically altered using procedures that include

1. Cricothyroid approximation (CTA) (is the most common)

2. Laryngoplasty3. Thyrohyoid approximation4. Laryngeal reduction surgery (surgical

shortening of the vocal cords)

Vocal Surgeries

Definition: Voice change surgery is a procedure done to alter the pitch of the voice in transsexuals. Surgery to raise the pitch of the voice so that it sounds more feminine in male-to-female transsexuals is done more frequently than surgery to lower voice pitch in female-to-male transsexuals.

Also Known As: pitch-altering surgery, plastic surgery of the vocal cords, voice feminization surgery, phonosurgery, pitch-raising surgery, pitch-lowering surgery.

Laryngoplasty

The surgery is for patients whose voice pitch is consistently interpreted as male. The typical patient will be a male who has or is undergoing transgender surgeries and wishes to change the voice pitch and potentially other qualities of the voice as well.

Indications

It is very essential to evaluate and examine your voice box. During the examination, the physician records a number of your vocal parameters. And then film your vocal cords in motion. The complete examination of your voice takes about an hour.

STEPS:Consultation Stroboscope- is an instrument used to view the

movement of your voice box and to record the sound of your voice.

Endoscopes - to view the voice box around the corners of the nose and mouth. Rigid StroboscopyRigid laryngoscopyFlexible laryngoscopy

Pre-surgery

Anesthesia to prevent gagging, sneezing, discomfort and obtain an ultra close view of the vocal folds. Anesthesia for rigid endoscopy

Video camera to record the voice boxLighting various lights show different details.Video tape recorder a method to review the

motion and structure of the vocal folds in high detail.

Technique- the hand of the person using the tool can make all the difference!

Pre-surgery

Physical Examination:The vocal cords and larynx are thoroughly

examined to check the voice frequency, structure, and shape.

Any prevailing colds or cough should be treated first.

Absolutely no food intake 6 hours before the surgery.

 Signing of surgical procedure consent form.

Pre-surgery

The hand of the person using the tool can make all the difference!

The surgery is performed in an outpatient setting under general anesthesia.

After you are asleep, an incision is placed parallel to or in a skin crease of your neck over the Adam’s apple. The front of the voice box is removed thus making the voice box smaller. (This removes the projection of the Adam's apple at the same time.

The vocal cords are then stretched and the front third to half of the cords are removed to shorten them.

The Surgical Procedure:

A large Medical silk or a tiny metal plate may be used over the voice box to maintain the tension on the vocal cords as well as hold the incised cartilage together during the healing period. It is a small plate and remains in place even when everything is healed.

A thyrohyoid elevation may also be performed at the same time to try raising the voice box in the neck. This attempts to shorten the pharynx to feminize a portion of the resonance chamber (pharynx). A thyrohyoid elevation consists of passing sutures around the hyoid bone to hold the voice box in an elevated position in the neck.

The Surgical Procedure:

The patient should stay in the hospital for two nights for close monitoring by the attending surgeon.

Complete voice rest is mandatory for one week after the procedure. All forms of verbal communication are not allowed, including whispering. Thus, communication is done in writing or sign language to expedite the healing process.

No weight lifting for one month.

Instructions during Recovery

No coughing or heavy expectoration to avoid irritation or inflammation of the vocal cords.

Patient is absolutely on soft diet.Soft diets with hormonal treatment ( if any) are

taken in the morning after surgery.Patient is subjected to a follow up check after 1

week for suture removal alongside with the speech therapy.

Instructions during Recovery

Thank you very much

Khop khun ka!