性别不安者嗓音变调手术相关喉结构的超声测量  

Ultrasonographic Measurement of Vocal Fold Length and Cricothyroid Distance for Transsexual Pitch Raising Surgery

作　　者：侯倩[1] 朱紫吟 江真[1] 任慧[1] 李革临[1] 

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,北京100050 [2]首都医科大学附属北京友谊医院超声科

出　　处：《听力学及言语疾病杂志》2017年第4期338-342,共5页Journal of Audiology and Speech Pathology

摘　　要：目的评估超声(ultrasonography)在性别不安者(gender dysphoria)嗓音变调手术前后喉结构测量方面的应用价值。方法选取2016年8月至2017年4月就诊于首都医科大学附属北京友谊医院有改变音调意愿的性别不安者(男变女,male to female,MtF)5例,4例行支撑喉镜下声带截短术(wendler glottoplasty)(其中1例同时行喉结成形术),1例行环甲接近术(cricothyroid approximation,CTA);所有患者术前、术后应用超声测量声带长度及环甲间隙距离,并于术后一个月测试嗓音基频(F0)。结果超声影像显示患者的喉结构及测量标志清晰,除1例同时行喉结成形术的患者术后未行超声检查外,余3例行声带截短术的MtF患者术前与术后超声测量声带长度差值(即声带截短长度)分别为0.37 cm(21%)、0.69 cm(37%)、0.40 cm(25%)。行环甲接近术的MtF患者术前超声测量环甲间隙距离为1.0 cm,术后为-0.33 cm,环状软骨上移1.33 cm,而术前和术后CT测量环甲间隙分别为0.91和-0.30 cm,环状软骨上移1.2 cm,可见超声测量与CT测量结果基本一致。除1例外,其余4例患者术后1个月嗓音F0均较术前明显升高。结论喉结构超声测量可为性别不安者嗓音变调手术提供客观喉部测量数据,对术前与术后评估有重要应用价值。Objective To assess true vocal fold（TVF）length and cricothyroid distance（CTD）with ultrasonography in male-to-female（MtF）transsexual voice surgery.Methods Five MtF transsexuals were divided into two groups according to their voice change surgery methods.High-frequency ultrasonography was used to measure the length of true vocal folds and cricothyroid distance.Measurements were compared pre-and post-surgery,and correlations with fundamental frequency （F0） were analyzed.Results The ultrasonography measurements clearly showed the laryngeal structure and TVF measurement marks.After vocal fold shortening and retrodisplacement of anterior commissure （VFSRAC） surgery,the ultrasonographic measurements showed that the shortening length of TVF were 0.37 cm（21%）,0.69cm（37%）and 0.40 cm（25%）,respectively.The CTD in ultrasonographicimages were 1.0 cm pre-surgery of cricothyroid approximation（CTA） and-0.33 post-surgery of CTA.The displacement of cricoid cartilage was 1.33 cm,which was consistent with the laryngeal CT image.Conclusion Both TVF length and CTD can be shown by high-frequency ultrasonography,which can be used to quantitatively assessment and follow-up MtF transsexual voice surgery.

关 键 词：性别不安者 超声 环甲接近术 声带截短术 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]