Isshiki N, Taira T, Tanabe M
J Otolaryngol. 1983 Oct;12(5):335-40.
Vocal pitch can be changed surgically without distorting the vocal quality. It can effectively be lowered by thyroplasty III, that is anteroposterior shortening of the thyroid ala by vertical strip excision of the cartilage. The pitch lowering was dramatic in six, but fair in three where the vocal cords were atrophic or scarred. Vocal pitch can be elevated by various surgical techniques: 1) cricothyroid approximation, 2) A-P expansion of the thyroid ala, 3) longitudinal incisions in the cords, 4) intrachondral injection of the steroid, and 5) evaporation of the cords by CO2 laser. Cricothyroid approximation, performed on 11 patients, generally produced substantial rise in pitch, which was limited, however, when the cords were very thick. The intrachordal surgeries, 3-5, should be performed conservatively, because it may interfere with the vocal cord vibration.
可以通过手术改变音调而不影响嗓音质量。通过III型甲状成形术，即通过垂直条状切除软骨使甲状腺翼板前后缩短，可以有效地降低音调。6例患者音调降低显著，3例声带萎缩或瘢痕化患者音调降低效果一般。可以通过多种手术技术提高音调：1）环甲肌靠拢术；2）甲状腺翼板前后扩张术；3）声带纵向切开术；4）软骨内注射类固醇；5）二氧化碳激光汽化声带。对11例患者进行的环甲肌靠拢术通常使音调大幅升高，然而，当声带非常厚时，升高幅度有限。3 - 5项声带内手术应谨慎进行，因为这可能会干扰声带振动。
