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Follow-up Trends in Patients Undergoing Modified Wendler Glottoplasty
Journal article   Open access

Follow-up Trends in Patients Undergoing Modified Wendler Glottoplasty

Ian D. Bowers, Yue Ma, Tyler W. Crosby, Clark A. Rosen, Steven D. Stockton, Sarah L. Schneider and VyVy N. Young
Laryngoscope, Vol.135(4)
2025

Abstract

Adult Female Follow-Up Studies Glottis Humans Laryngoplasty Lost to Follow-Up Male Middle Aged Retrospective Studies Article chronic disease clinical article electronic medical record endoscopic surgery ethnicity facial feminization surgery feminization surgery follow up gender affirming surgery gender dysphoria gender-affirming care human logistic regression analysis male to female transgender mental disease mental health care modified Wendler glottoplasty patient compliance patient counseling patient-reported outcome perception pitch postoperative care preoperative care questionnaire retrospective study social status speech language pathologist surgical technique transgender trend study vocal cord voice voice handicap index-10 voice training procedures Cohort Analysis Surgery
Objectives: After modified Wendler glottoplasty (mWG), close follow-up with laryngologist and speech-language pathologist (SLP) is thought to be essential to achieve best outcomes. This study presents a case series of patients undergoing mWG at a single institution to identify factors associated with trends in post-operative follow-up. Methods: Retrospective review of trans women patients who underwent mWG between March 2018 and July 2023 was performed. Demographic data, pre-operative care, and post-operative course were reviewed. Lost to follow-up (LTFU) was defined as a failure to return to the office or schedule a follow-up appointment as recommended, for ≥2 months after last visit. Logistic regressions were utilized to identify possible factors associated with being LTFU. Results: Eight (50%) of 16 patients met LTFU criteria. Patients were considered not LTFU if they completed care (n = 3, 19%) or were still undergoing care (n = 5, 31%). Patients with chronic diseases were less likely to become LTFU (p = 0.03). Those lost to follow-up had more no-show visits (p = 0.04). Total number of gender-affirming surgeries, distance from hospital, socioeconomic status of residential zip code, race/ethnicity, other psychological history, and patient-reported outcome measure scores did not affect LTFU rates. Conclusion: Fifty percent of patients were LTFU after modified Wendler glottoplasty. Even one no-show visit increased risk of being LTFU, whereas the presence of chronic diseases was protective against this. This study illustrates that increased efforts are needed following mWG to better understand the factors associated with being LTFU and to facilitate patients' ability to complete post-operative care successfully. Level of Evidence: 4 Laryngoscope, 135:1431–1437, 2025. © 2024 The American Laryngological, Rhinological and Otological Society, Inc.
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https://doi.org/10.1002/lary.31863View
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