Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Speech & Language Pathology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
Ann Otol Rhinol Laryngol. 2021 Sep;130(9):1057-1063. doi: 10.1177/0003489421993728. Epub 2021 Feb 10.
Laser reduction glottoplasty is a relatively new surgical procedure for voice feminization on transgender women. This study aims to determine long-term voice results of glottoplasty on transwomen.
Nonrandomized, retrospective, cohort. Tertiary referral center. Endoscopic laser reduction glottoplasty was performed on 28 transwomen. Voice Handicap Index (VHI-30), Transsexual Voice Questionnaire (TVQ), acoustic analysis with /a/ for F, jitter, shimmer, noise to harmonic ratio and acoustic analysis for speaking F were measured before and after surgery. Patients self-evaluated their postoperative voices and medical students and 2 voice experts scored patients' pre- and postsurgery voice samples as masculine, feminine or neither.
Mean total VHI and TVQ scores improved significantly postoperatively ( < .001). Pre- and postsurgery mean F were 132 and 198 Hz and mean speaking F were 123 and 194 Hz, respectively; these variations were found statistically significant ( < .001). Postoperative mean jitter, shimmer and NHR increased significantly compared to preoperative values ( < .05). Nine patients (32%) were not happy with their postsurgery voice result and were offered anterior glottic web formation as secondary procedure. MFT women's self-ratings of their postsurgery voices showed 3 masculine, 19 feminine and 6 neither outcomes, leading to patient gratification score of 68%. Medical students evaluated 79% of postsurgery voice specimens as feminine. Voice experts evaluated 75% of postsurgery voice specimens as feminine.
Laser reduction glottoplasty is an accomplished and satisfying operation for feminizing voice of transwomen. Its voice outcome appears to be durable for 5 years. However, secondary operation may be needed to further gratify transwomen.
激光杓状软骨缩小成形术是一种用于 transgender 女性的声带女性化的相对较新的手术方法。本研究旨在确定 glottoplasty 对跨性别女性的长期语音效果。
非随机、回顾性、队列研究。三级转诊中心。对 28 名跨性别女性进行内镜激光杓状软骨缩小成形术。术前和术后分别测量嗓音障碍指数（VHI-30）、跨性别嗓音问卷（TVQ）、以/a/进行声学分析的 F、抖动、颤抖、噪声与谐波比以及说话 F 的声学分析。患者对术后嗓音进行自我评估，医学学生和 2 名嗓音专家对患者术前和术后的嗓音样本进行评分，判断为男性、女性或非男非女。
总 VHI 和 TVQ 评分平均术后显著改善（ < .001）。术前和术后的平均 F 分别为 132 和 198 Hz，平均说话 F 分别为 123 和 194 Hz，这些变化具有统计学意义（ < .001）。与术前相比，术后平均抖动、颤抖和 NHR 显著增加（ < .05）。9 名患者（32%）对术后嗓音结果不满意，并接受了前声带网形成术作为二级手术。MFT 女性对术后嗓音的自我评估显示 3 人声音男性化，19 人声音女性化，6 人声音中性，患者满意度评分为 68%。医学学生评估术后嗓音样本的 79%为女性化。嗓音专家评估术后嗓音样本的 75%为女性化。
激光杓状软骨缩小成形术是一种成功且令人满意的 transgender 女性声带女性化手术。其嗓音效果似乎可持续 5 年。然而，可能需要二次手术进一步满足跨性别女性的需求。
