Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Patras, Patras, Greece.
J Voice. 2013 Jul;27(4):516-22. doi: 10.1016/j.jvoice.2013.04.004.
Evaluation of the voice results after Wendler glottoplasty in male-to-female transsexuals (MFTs).
Retrospective case series.
We retrospectively reviewed 31 MFT patients treated with a Wendler glottoplasty technique. The procedure consists of the CO2-laser de-epithelialization of the anterior commissure along with the anterior third of the two vocal folds, the suturing of the two vocal folds with two 3.0 resorbable threads, and next, the application of fibrin sealant to strengthen the stitches. Voice assessment was based mainly on fundamental frequency, frequency range, maximum phonation time, phonation quotient, estimated subglottic pressure (ESGP), grade of dysphonia (G), and voice handicap index. The measurements were performed preoperatively and on the last follow-up visit and compared using IBM SPSS 20 statistical package (IBM Corp, Armonk, NY). The patients have been divided in two groups (group A younger than 40 years and group B of or older than 40 years) for assessing the influence of the age of treatment on the results.
Group A included 19 individuals with mean age of 28.6 years (range: 16-39 years) and group B included 12 individuals with mean age of 51.9 years (range: 45-59 years). The mean follow-up period was 9.2 months. Three cases had previously undergone a cricothyroid approximation elsewhere. We found a significant improvement of mean F0 from 135.8 to 206.3Hz in total (P = 0.001) and also in both groups, especially in group A (mean F0-postop = 213.8Hz). The mean frequency range had a tendency to decrease postoperatively, whereas the ESGP was significantly higher in both total sample and group A (P = 0.001, respectively). G was increased postoperatively and presented a statistical significance in group B (P = 0.035). A revision Wendler procedure was necessary for three individuals (9.7%); two of them presented a suture's line breakdown because they did not follow the postoperative recommendations for voice rest and the third one had an insufficient web due to an insufficient estimation of the necessary correction.
Wendler glottoplasty seems to be an effective technique to feminize the voice in MFTs with better results when performed in younger individuals.
评估 Wendler 声门成形术在男变女跨性别者（MTF）中的嗓音效果。
回顾性病例系列研究。
我们回顾性地分析了 31 名接受 Wendler 声门成形术治疗的 MTF 患者。该手术包括 CO2 激光去除前连合和前 3 条声带的上皮化，用两条 3.0 可吸收缝线缝合两条声带，然后应用纤维蛋白密封剂加强缝线。嗓音评估主要基于基频、频率范围、最长发声时间、发声商、估计的声门下压（ESGP）、嗓音障碍程度（G）和嗓音障碍指数。这些测量是在术前和最后一次随访时进行的，并使用 IBM SPSS 20 统计软件包（IBM Corp，Armonk，NY）进行比较。根据治疗年龄将患者分为两组（A 组<40 岁，B 组≥40 岁），以评估年龄对结果的影响。
A 组包括 19 名患者，平均年龄为 28.6 岁（范围：16-39 岁），B 组包括 12 名患者，平均年龄为 51.9 岁（范围：45-59 岁）。平均随访时间为 9.2 个月。3 例患者此前曾在其他地方行环甲软骨接近术。我们发现总 F0 从 135.8Hz 显著增加到 206.3Hz（P=0.001），且在两组中，尤其是 A 组（术后平均 F0=213.8Hz），F0 也显著增加。平均频率范围术后有下降趋势，而 ESGP 在总样本和 A 组中均显著升高（P=0.001 和 P=0.001）。G 术后增加，B 组有统计学意义（P=0.035）。3 名患者（9.7%）需要进行 Wendler 修复手术，其中 2 名患者由于未遵循术后嗓音休息的建议而导致缝线线断裂，第 3 名患者由于对所需矫正的估计不足而导致网织结构不足。
Wendler 声门成形术似乎是一种有效的技术，可以改善 MTF 的嗓音，使其女性化，在年轻患者中效果更好。
