Eric Delgado Rendon, Logan Bassoff, Gabriela Chalela, Natalia M Kabat, Amy Rutt
The published literature on type III thyroplasty for vocal masculinization remains extremely limited, consisting primarily of small case reports and case series with heterogeneous techniques and short follow-up durations. While reductions in fundamental frequency have been reported, current evidence is insufficient to determine long-term effectiveness, durability, functional voice outcomes, or safety. Prospective studies with standardized outcome measures and extended follow-up are needed before clinical recommendations can be established. Future studies should incorporate multidimensional voice assessment, including patient-reported outcomes, vocal intensity, projection, and long-term quality-of-life measures.
OBJECTIVE: To characterize current literature on outcomes of type III thyroplasty for vocal masculinization among transmasculine patients.
DATA: MEDLINE, Embase, Scopus, CINAHL, CENTRAL, ClinicalTrials.gov, and Google Scholar.
METHODS: A comprehensive search of databases was conducted from inception through August 10, 2025. Studies eligible for inclusion must have reported on adult transmasculine patients undergoing type III thyroplasty for vocal masculinization. Articles were independently screened and reviewed by two authors for fundamental frequency outcomes, patient-reported vocal and quality-of-life measures, and complications.
RESULTS: Of 1042 studies screened, 4 met the inclusion criteria (n = 23). Across studies, postoperative reductions in fundamental frequency were reported, although surgical techniques, outcome measures, and follow-up durations varied substantially. One patient (4.3%) developed transient subcutaneous emphysema that resolved without sequelae. Patient-reported outcomes were inconsistently assessed, with limited reports of improved voice-related quality of life, reduced dysphoria, and decreased misgendering.
CONCLUSION: The published literature on type III thyroplasty for vocal masculinization remains extremely limited, consisting primarily of small case reports and case series with heterogeneous techniques and short follow-up durations. While reductions in fundamental frequency have been reported, current evidence is insufficient to determine long-term effectiveness, durability, functional voice outcomes, or safety. Prospective studies with standardized outcome measures and extended follow-up are needed before clinical recommendations can be established. Future studies should incorporate multidimensional voice assessment, including patient-reported outcomes, vocal intensity, projection, and long-term quality-of-life measures.