Stephanie Benoit April 26, 2016

Gender reassignment surgery has come a long way since Dr. Magnus Hirschfeld performed some of the world’s first male-to-female operations in Berlin in the 1930’s. Transsexual men and women are able to reassign their gender with a much higher degree of success than in those early 20th century operations, and the medical field is continuously advancing its possibilities. Mimics Innovation Award winner Dr. Claudio Storck is one such researcher evolving the boundaries of what is possible. A specialist in Otolaryngology, or the field of medicine which deals with the ear, nose and throat region, he has focused his research on improving the outcome of phonosurgery in transgender patients.

A patient of Dr. Magnus Hirschfeld | © Wellcome Library, London
A patient of Dr. Magnus Hirschfeld | © Wellcome Library, London

A person’s voice is a fundamental part of their identity; it is one of the main tools of communication we use to connect with other people. So it is entirely natural that a male patient transitioning to the female gender would want their voice to reflect that gender. Sometimes speech therapy does the trick, but when that fails, one of the most common procedures used by laryngologists is cricoid-thyroid approximation (referred to as CTA). By joining the cricoid cartilage to the thyroid cartilage, the length and tension of the vocal cord is increased, thereby giving the patient a higher (and more feminine) voice.

Antero-lateral view of the larynx | © Olek Remesz
Antero-lateral view of the larynx | © Olek Remesz

Unfortunately, CTA doesn’t always work for everyone, and Dr. Storck was determined to find out why, and how this could be changed. Using 3D images taken from CT scans of the patients, Dr. Storck was able to distinguish three clear types of cricoid-thyroid joints (CTJ). And the success of the CTA operation also had a direct correlation to the different types of cricoid-thyroid joints. Without getting too technical, there was only one type of CTJ, type A, which was optimal for the CTA surgery, and for patients with type B or C the surgery was unsuccessful. By using Dr. Storck’s 3D imaging method, surgeons should be able to determine if their patient is a likely candidate for the surgery, and Dr. Storck now standardly uses 3D images before performing a CTA operation.

View from the left on a right hemi-larynx with the superimposed preoperative and postoperative positions of the cricoid plate
View from the left on a right hemi-larynx with the superimposed preoperative and postoperative positions of the cricoid plate

Although this research still doesn’t help transgender women with a CTJ of type B or C to get their ideal voice, it does save them an unnecessary surgery and all the frustration that comes with an unsatisfactory result. But you never can tell: in future, the medical field might have evolved enough to help even those patients. Interested in learning more about Dr. Storck’s research? Take a look at his story on our medical blog! If you’re an aspiring researcher using Materialise Mimics, why not enter your research in the Mimics Innovation Awards? Read all about it here.