Surgical techniques in chondrolaryngoplasty: a narrative review.

Introduction: Chondrolaryngoplasty, also known as "Adam's apple" reduction, is a surgical procedure that diminishes the prominence of the thyroid cartilage. Primarily sought by transgender women, the procedure is performed for esthetic reasons to align with their identified gender. It can also be done for cisgender individuals seeking reduced prominence. Despite its safety, there are risks due to the proximity to vocal cords, and variations may impact results.

Objective: To identify the main techniques available in the literature for performing chondrolaryngoplasty, as well as the differences in the results of each technique applied.

Methods: Research utilized databases (MEDLINE, PubMed, and Scopus) from inception to March 2023, focusing on randomized clinical trials, prospective and retrospective studies, and case series published in English, Spanish, French, or Portuguese. Selected studies provided results including satisfaction rates, surgical time, and/or details on complications.

Results: 21 eligible results, four of which were excluded because the full text was not available and four because they did not meet the research objectives. Thus, 13 articles were included in the analysis, eight of which reported on external approach surgical procedures (via surgical incision) and five on transoral procedures, totaling 355 living patients evaluated, as well as 11 cadavers. The complications reported are considered mild and transient, and do not contraindicate the procedure. Among the factors that most interfere with patient satisfaction is the apparent scar, which is avoided with the transoral surgical approach, which has been reported more recently.

Conclusion: Chondrolaryngoplasty is an esthetic surgical procedure that aims to reduce the prominence of the thyroid cartilage and is most commonly performed on transgender women. Studies show that it is a safe procedure, with rare complications that are generally transient. The main drawback of the surgery is the apparent scar which can be avoided by a transoral approach.