Yılmaz Taner
Department of Otolaryngology-Head & Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Laryngoscope. 2024 Mar;134(3):1133-1138. doi: 10.1002/lary.30958. Epub 2023 Aug 9.
Voice feminizing surgery is frequently needed for transgender female patients. Among several surgical options, Wendler glottoplasty (WG) and laser reduction glottoplasty (LRG) are two endoscopic procedures. However, because a single procedure may not produce sufficient benefit, the two surgeries may sometimes be sequentially performed. This study was carried out to present the voice results of such sequential surgeries.
This is an individual retrospective cohort study, performed at a tertiary referral center, that is a university hospital. 18 transgender patients were treated with WG initially and then underwent LRG; 17 had LRG first then WG. All 35 cases were performed during a 15-year period and followed for at least 1 year postoperatively. Voice Handicap Index (VHI-30), transsexual voice questionnaire (TVQ), and acoustic analysis with /a/ and running speech were obtained pre- and postoperatively.
VHI and TVQ improved significantly postoperatively (p < 0.05). Their preoperative, first, and second postoperative mean sF0 were 146, 175, and 215 Hz, respectively; these differences were statistically significant (p < 0.001). Their postoperative mean jitter percent, shimmer percent, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), and cepstral spectral index of dysphonia (CSID) worsened significantly compared to preop values (p < 0.05); however, mean postoperative acoustic results were still within normal limits. Patients' self-ratings of their postsurgery voices revealed all feminine, leading to a patient gratification score of 100%.
If transgender female patients are unsatisfied with their voice after WG or LRG, the addition of the alternative procedure may significantly feminize their voice. Sequential WG and LRG is a successful surgical option for voice feminization.
4 Laryngoscope, 134:1133-1138, 2024.
对于跨性别女性患者，常需要进行嗓音女性化手术。在多种手术选择中，温德勒声门成形术（WG）和激光减容声门成形术（LRG）是两种内镜手术。然而，由于单一手术可能无法产生足够的益处，有时可能会依次进行这两种手术。本研究旨在呈现此类序贯手术的嗓音结果。
这是一项在三级转诊中心（一所大学医院）进行的个体回顾性队列研究。18例跨性别患者先接受WG治疗，然后接受LRG；17例先接受LRG，然后接受WG。所有35例手术均在15年期间进行，并在术后至少随访1年。术前和术后获取嗓音障碍指数（VHI-30）、变性者嗓音问卷（TVQ）以及/a/音和连续语音的声学分析结果。
术后VHI和TVQ有显著改善（p < 0.05）。术前、首次术后和第二次术后的平均基频分别为146、175和215 Hz；这些差异具有统计学意义（p < 0.001）。与术前值相比，术后平均抖动百分比、闪烁百分比、噪声谐波比（NHR）、谐波峰值突出度（CPP）和嗓音障碍的谐波谱指数（CSID）显著恶化（p < 0.05）；然而，术后平均声学结果仍在正常范围内。患者对术后嗓音的自我评价均为女性化，患者满意度得分为100%。
如果跨性别女性患者在WG或LRG后对其嗓音不满意，增加另一种手术可能会显著使其嗓音女性化。序贯WG和LRG是嗓音女性化的一种成功手术选择。
4 喉镜，134:1133 - 1138，2024。
