How does Cricotracheal Resection Affect the Female Voice?

Abstract

Objectives We measured the effects of cricotracheal resection on the adult female voice. Methods Voice recordings of 14 women (mean age, 53 years; range, 35 to 69 years) who underwent cricotracheal resection for chronic airway obstruction associated with idiopathic laryngotracheal stenosis were acquired before and after surgery. The recordings were analyzed with voice analysis software. The measures included the mean fundamental frequency of a sustained vowel at a comfortable pitch and loudness (F0), the mean F0 of connected speech (ie, speaking F0), the pitch range (F0 range), and the maximum phonation time. Self-assessment measures of the Voice Handicap Index were taken. Results The mean speaking F0 lowered significantly, by 21 Hz, from 186 Hz to 165 Hz (p = .04). In 7 patients, the speaking F0 was below 160 Hz after the operation. The mean sustained vowel frequency also dropped by 32 Hz (p = .03). The F0 range was reduced by an average of 5.9 semitones, from 21.5 to 15.6 (p = .05). The maximum phonation time did not change significantly. The postoperative mean Voice Handicap Index score was 21.9. Conclusions Cricotracheal resection can significantly impact the adult female voice. It often lowers the pitch of the speaking voice into the male range and reduces the pitch range of the voice. The change in voice that potentially accompanies this procedure should be discussed with patients in preoperative counseling.