The Laryngoscope
June 22, 2026 · via Europe PMC
Impact of Infraglottic Capture in Anterior Glottoplasty Pitch Elevation in an Ex Vivo Porcine Model.
Arora N, Ma Y, Young VN, Schneider SL, Rosen CA, Crosby TW.
AI summary — for doctors, generated from the abstract only
In a pig larynx model, anterior glottoplasty webs that captured the full infraglottic vibratory surface raised pitch more consistently than superior-edge-only webs.
What was studied
Ex vivo experiment on eight porcine larynges comparing baseline, thin web and thick web endoscopic vocal fold shortening at the same anteroposterior position.
Key findings
- Baseline F0 was 361.5 Hz; thin webs raised it to 535.1 Hz with high variability (p=0.445).
- Thick webs raised F0 to 652.0 Hz significantly (p=0.023).
- Thick versus thin did not reach significance (p=0.117).
Clinical relevance
Suture depth may be a modifiable variable for pitch elevation in gender-affirming voice surgery.
Who should care
Limitations
Ex vivo animal model with only eight specimens, and the thick versus thin difference was not statistically significant.
Consider depth of web capture when planning pitch elevation, pending human evidence.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Endoscopic vocal fold shortening (EVFS) often focuses on the anterior-posterior (AP) web dimension as a proportion of vocal fold (VF) length. We investigated the craniocaudal dimension to determine whether thick infraglottic web geometry produces greater fundamental frequency (F0) elevation than thin webs of equivalent AP dimension.
Methods
Supraglottic structures were removed from eight porcine larynges. Compressed air passed through the glottis achieved phonation under three conditions: baseline, thin web, and thick web. Thin web sutures placed at a mean of 37% of VF length captured only the superior free edge; thick web sutures placed at the same AP position captured the entire infraglottic vibratory surface. F0 was extracted from audio recordings. Wilcoxon signed-rank tests with Bonferroni correction compared F0 elevation between conditions.
Results
Baseline F0 was 361.5 Hz (IQR: 308.7-392.0 Hz). Thin webs elevated F0 to 535.1 Hz (Hodges-Lehmann estimated shift [HL] +162.6 Hz [95% CI: -39.3-382.5 Hz]) but with high interspecimen variability (V = 29, p = 0.445). Thick webs produced a more consistent, significant elevation from baseline F0 to 652.0 Hz (V = 36, p = 0.023; HL +255.4 Hz [95% CI: 68.1-452.9 Hz]). Thick webs produced greater F0 elevation than thin webs but did not reach significance (V = 33, p = 0.117; HL +78.9 Hz [95% CI: 1.3-282.9 Hz]).
Conclusion
This model demonstrates that EVFS three-dimensional web geometry impacts F0 elevation not only through its AP dimension but also through incorporation of the infraglottic vibratory surface. Deliberate infraglottic capture may represent a technically modifiable variable to optimize pitch elevation in gender-affirming voice surgery.
Level of evidence
NA.
DOI
10.1002/lary.70707
PMID
42325050
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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