The Role of Voice Therapy and Phonosurgery in Transgender Vocal Feminization

Journal of Craniofacial Surgery - Tập 30 Số 5 - Trang 1368-1375 - 2019
Ian T. Nolan1,2,3, Shane D. Morrison4,1,3, Omotayo Arowojolu2, Christopher S. Crowe4, Jonathan P. Massie5, Richard K. Adler6, Scott R. Chaiet7, David O. Francis7
1Ian T. Nolan, BM, New York University School of Medicine, New York, NY 98104
2New York University School of Medicine, New York, NY
3reprint requests to Shane D. Morrison, MD, MS, Division of Plastic Surgery, University of Washington Department of Surgery, 7CT73.1 Harborview Medicine Center, 325 9th Avenue, Mailstop #359796, Seattle, WA 98104
4Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA
5Division of Plastic Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
6Emeritus Faculty, Speech Language and Hearing Sciences Department, Minnesota State University Moorehead, Moorehead, MN
7Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.

Tóm tắt

Objective: Nonsurgical and surgical options are available for transgender vocal feminization. This systematic review explores the efficacy of feminizing voice therapy and phonosurgery. Methods: A systematic review was performed using PubMed, Cinahl Plus, Ovid SP, Web of Science, Science Direct, and Google Scholar with terms related to transgender phonosurgery and voice therapy. Included studies were outcomes-based vocal feminization interventions for transgender women. Data were collected on pre- and postintervention fundamental frequency (F0), externally measured vocal femininity, patient satisfaction, and complications. Results: Two hundred twelve studies were identified and 20 met inclusion criteria. Postintervention patient satisfaction was approximately 80% to 85% for voice therapy, endoscopic shortening, and cricothyroid approximation. Complications were reported for each phonosurgery technique, most commonly decreased mean phonation time and loudness. Of the 20 studies, 17 were used for meta-analysis of F0 change. F0 increased by 31 Hz with voice therapy alone, 26 Hz with laser reduction glottoplasty, 39 Hz with cricothyroid approximation, and 72 Hz with endoscopic shortening. Conclusion: The literature supports both voice therapy and phonosurgery, depending on a patient's magnitude of desired pitch change and tolerance for cost and potential complications. Most will likely benefit from voice therapy, as it is highly satisfactory, raises vocal pitch, and is noninvasive. However, endoscopic shortening is also highly satisfactory and provides the greatest absolute increase in vocal pitch. If surgery is chosen, postoperative voice therapy may additionally increase F0, stabilize the voice, and create a more female timbre. However, further studies will be necessary to provide definitive clinical recommendations.

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Tài liệu tham khảo

2015, Guidelines for psychological practice with transgender and gender nonconforming people, Am Psychol, 70, 832, 10.1037/a0039906

Winter, 2016, Synergies in health and human rights: a call to action to improve transgender health, Lancet, 388, 318, 10.1016/S0140-6736(16)30653-5

Spencer, 1988, Speech characteristics of male-to-female transsexuals: a perceptual and acoustic study, Folia Phoniatr (Basel), 40, 31, 10.1159/000265881

Davies, 2015, Voice and communication change for gender nonconforming individuals: giving voice to the person inside, Int J Transgenderism, 16, 117, 10.1080/15532739.2015.1075931

Simpson Adrian, 2009, Phonetic differences between male and female speech, Lang Linguistics Compass, 3, 621, 10.1111/j.1749-818X.2009.00125.x

Song, 2017, Transgender phonosurgery: a systematic review and meta-analysis, Otolaryngol Head Neck Surg, 156, 803, 10.1177/0194599817697050

Gelfer, 2013, Perceptual and acoustic outcomes of voice therapy for male-to-female transgender individuals immediately after therapy and 15 months later, J Voice, 27, 335, 10.1016/j.jvoice.2012.07.009

Dacakis, 2000, Long-term maintenance of fundamental frequency increases in male-to-female transsexuals, J Voice, 14, 549, 10.1016/S0892-1997(00)80010-7

Davies, 2006, Clinical aspects of transgender speech feminization and masculinization, Int J Transgenderism, 9, 167, 10.1300/J485v09n03_08

Carew, 2007, The effectiveness of oral resonance therapy on the perception of femininity of voice in male-to-female transsexuals, J Voice, 21, 591, 10.1016/j.jvoice.2006.05.005

Gelfer, 2013, A preliminary study on the use of vocal function exercises to improve voice in male-to-female transgender clients, J Voice, 27, 321, 10.1016/j.jvoice.2012.07.008

Hancock, 2013, Transgender voice and communication treatment: a retrospective chart review of 25 cases, Int J Lang Commun Disord, 48, 54, 10.1111/j.1460-6984.2012.00185.x

Meszaros, 2005, Efficacy of conservative voice treatment in male-to-female transsexuals, Folia Phoniatr Logop, 57, 111, 10.1159/000083572

Casado, 2016, Wendler glottoplasty and voice-therapy in male-to-female transsexuals: Results in pre and post-surgery assessment. [Spanish], Acta Otorrinolaringol Esp, 67, 83, 10.1016/j.otorri.2015.02.003

Kim, 2017, A new conceptual approach for voice feminization: 12 years of experience, Laryngoscope, 127, 1102, 10.1002/lary.26127

Remacle, 2011, Glottoplasty for male-to-female transsexualism: voice results, J Voice, 25, 120, 10.1016/j.jvoice.2009.07.004

Orloff, 2006, Laser-assisted voice adjustment (LAVA) in transsexuals, Laryngoscope, 116, 655, 10.1097/01.mlg.0000205198.65797.59

Kocak, 2010, Laser reduction glottoplasty for managing androphonia after failed cricothyroid approximation surgery, J Voice, 24, 758, 10.1016/j.jvoice.2009.06.004

Yang, 2002, Cricothyroid approximation to elevate vocal pitch in male-to-female transsexuals: results of surgery, Ann Otol Rhinol Laryngol, 111, 477, 10.1177/000348940211100602

Neumann, 2004, The importance of the voice in male-to-female transsexualism, J Voice, 18, 153, 10.1016/S0892-1997(03)00084-5

Van Borsel, 2008, Feminine after cricothyroid approximation?, J Voice, 22, 379, 10.1016/j.jvoice.2006.11.001

Meister, 2016, Patient satisfaction after pitch elevation and development of a therapy algorithm, Laryngorhinootologie, 95, 774

Morrison, 2017, Beyond Phonosurgery: Considerations for Patient-Reported Outcomes and Speech Therapy in Transgender Vocal Feminization, Otolaryngol Head Neck Surg, 157, 349, 10.1177/0194599817712678

Morrison, 2017, Consistent quality of life outcome measures are needed for facial feminization surgery, J Craniofac Surg, 28, 851, 10.1097/SCS.0000000000003450

Gross, 1999, Pitch-raising surgery in male-to-female transsexuals, J Voice, 13, 246, 10.1016/S0892-1997(99)80028-9

Anderson, 2014, Pitch elevation in trangendered patients: anterior glottic web formation assisted by temporary injection augmentation, J Voice, 28, 816, 10.1016/j.jvoice.2014.05.002

Brown, 2000, Pitch change in male-to-female transsexuals: has phonosurgery a role to play?, Int J Lang Commun Disord, 35, 129, 10.1080/136828200247296

Van Borsel, 2014, The voice in transsexuals, Revista de Logopedia, Foniatría y Audiología, 34, 40, 10.1016/j.rlfa.2013.04.007

Kanagalingam, 2005, Cricothyroid approximation and subluxation in 21 male-to-female transsexuals, Laryngoscope, 115, 611, 10.1097/01.mlg.0000161357.12826.33

Mastronikolis, 2013, Wendler glottoplasty: an effective pitch raising surgery in male-to-female transsexuals, J Voice, 27, 516, 10.1016/j.jvoice.2013.04.004

Dacakis, 2017, Associations between the Transsexual Voice Questionnaire (TVQ(MtF)) and self-report of voice femininity and acoustic voice measures, Int J Lang Commun Disord, 52, 831, 10.1111/1460-6984.12319

Massie, 2017, Patient-reported outcomes in gender confirming surgery, Plast Reconstr Surg, 140, 236e, 10.1097/PRS.0000000000003479

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Thông tin xuất bản

Journal of Craniofacial Surgery

Tập 30 Số 5

1368-1375

Thông tin tác giả