D'haeseleer Evelien, Papeleu Tine, Leyns Clara, Adriaansen Anke, Meerschman Iris, Tomassen Peter
Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Musical Department, Royal Conservatory Brussels, Erasmushogeschool Brussel, Brussels, Belgium.
Centre for Speech and Language Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
J Voice. 2023 Feb 9. doi: 10.1016/j.jvoice.2023.01.013.
This study investigates the short- and longer-term effects of glottoplasty up to six months after surgery on acoustic voice parameters, listener perceptions, and client's satisfaction in trans women. Secondly, the impact of chondrolaryngoplasty and voice therapy on the glottopasty outcomes was investigated.
A prospective longitudinal non-controlled trial was used. Thirty-five trans women undergoing glottoplasty or a combination of glottopasty and chondrolaryngoplasty were included in this study. A voice assessment was conducted before surgery and 1 week, 1 month and 6 months after surgery. The following outcome parameters were measured: fundamental frequency (f), intensity, frequency and intensity range, Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Voice Handicap Index (VHI), Trans Woman Voice Questionnaire (TWVQ), and visual analogue scales (VAS) measuring client's satisfaction. Listener perceptions of masculinity-femininity were collected using a listening experiment.
Significant differences over time were found for all f and intensity parameters, DSI, AVQI, VHI and TWVQ scores. Listener perception and self-perception of femininity was higher after surgery. Significant differences in evolution of listener perceptions were found between the groups with and without voice therapy.
Glottoplasty improves voice related quality of life and is an effective method to increase the f and associated perceptual femininity. After glottoplasty an immediate and short-term decrease in voice quality, vocal capacity and frequency range was measured with a progressive recovery on the longer term. Long term side effects of glottoplasty are a reduction in speaking intensity and intensity range. Voice therapy seems to improve the outcomes of glottoplasty, but should be further investigated in future studies.
本研究调查了声门成形术术后长达六个月对跨性别女性声学嗓音参数、听众感知及患者满意度的短期和长期影响。其次，研究了软骨喉成形术和嗓音治疗对声门成形术结果的影响。
采用前瞻性纵向非对照试验。本研究纳入了35名接受声门成形术或声门成形术与软骨喉成形术联合治疗的跨性别女性。在手术前以及术后1周、1个月和6个月进行嗓音评估。测量以下结果参数：基频（f）、强度、频率和强度范围、发声障碍严重程度指数（DSI）、声学嗓音质量指数（AVQI）、嗓音障碍指数（VHI）、跨性别女性嗓音问卷（TWVQ）以及测量患者满意度的视觉模拟量表（VAS）。通过听力实验收集听众对男性化 - 女性化的感知。
所有f和强度参数、DSI、AVQI、VHI和TWVQ评分随时间均有显著差异。术后听众对女性气质的感知和自我感知更高。接受嗓音治疗和未接受嗓音治疗的组在听众感知变化方面存在显著差异。
声门成形术可改善与嗓音相关的生活质量，是提高基频及相关感知女性气质的有效方法。声门成形术后，嗓音质量、发声能力和频率范围立即出现短期下降，长期逐渐恢复。声门成形术的长期副作用是说话强度和强度范围降低。嗓音治疗似乎可改善声门成形术的结果，但未来研究应进一步探讨。
