声带截短术用于跨性别女性音调提升的疗效分析  

The effect of Wendler Glottoplasty to elevate vocal pitch in transgender women

作　　者：张驰 侯倩[1] 郭婷婷 钟静婷 任慧[1] 李革临[1] Zhang Chi;Hou Qian;Guo Tingting;Zhong Jingting;Ren Hui;Li Gelin(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

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

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第2期139-144,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金(81900926);北京自然科学基金(7204246)。

摘　　要：目的评估声带截短术在提高跨性别女性嗓音音调中的疗效。方法回顾性分析2017年1月至2020年10月就诊于北京友谊医院耳鼻咽喉头颈外科的29例行显微支撑喉镜下声带截短术的跨性别女性术前及术后3个月的嗓音参数。29例跨性别女性年龄为19~47(27.0±6.3)岁。主观嗓音评估采用跨性别女性嗓音问卷(Transsexual Voice Questionnaire for Male to Female,TVQ^(MtF))。客观评估中分析了嗓音基频(F_(0))、最高音、最低音、习惯言语响度、Jitter、Shimmer、最长发声时间(MPT)、噪谐比(NHR)、共振峰(F1、F2、F3、F4)频率。采用SPSS 25.0软件进行统计学分析。结果与手术前相比,声带截短术后3个月后的TVQ^(MtF)评分明显下降[(89.9±14.7)分vs.(50.4±13.6)分,t=11.49,P<0.001],F_(0)水平明显提高[(152.7±23.3)Hz vs.(207.7±45.9)Hz,t=-6.03,P<0.001]。共振峰F1、F2和F3频率较术前明显提高,F4频率与术前的差异无统计学意义。患者的最高音无明显改变,但最低音较术前有明显提高[(96.8±17.7)Hz vs.(120.0±28.9)Hz,t=-3.71,P=0.001]。习惯言语响度较术前有明显提高[(60.0±5.2)dB vs.(63.6±9.6)dB,t=-2.12,P=0.043]。Jitter、Shimmer、NHR及MPT与术前的差异均无统计学意义(P值均>0.05)。结论声带截短术能够显著提高跨性别女性的嗓音基频、共振峰频率及嗓音女性化程度,对发音能力及嗓音质量无明显不利影响,是嗓音女性化的有效治疗措施之一。Objective To evaluate the effect of Wendler Glottoplasty to elevate vocal pitch in transgender women.Methods The voice parameters of pre-and 3-month post-surgery of 29 transgender women who underwent Wendler Glottoplasty in department of otorhinolaryngology head and neck surgery of Beijing Friendship Hospital from January,2017 to October,2020 were retrospectively analyzed.The 29 transgender women ranged in age from 19-47(27.0±6.3)years old.Subjective evaluation was performed using Transsexual Voice Questionnaire for Male to Female(TVQ^(MtF)).Objective parameters included fundamental frequency(F_(0)),highest pitch,lowest pitch,habitual volume,Jitter,Shimmer,maximal phonation time(MPT),noise to harmonic ratio(NHR)and formants frequencies(F1,F2,F3,F4).SPSS 25.0 software was used for statistically analysis.Results Three months after surgery,the score of TVQ^(MtF) was significantly decreased[(89.9±14.7)vs.(50.4±13.6),t=11.49,P<0.001].The F_(0) was significantly elevated[(152.7±23.3)Hz vs.(207.7±45.9)Hz,t=-6.03,P<0.001].Frequencies of F1,F2 and F3 were significantly elevated.No statistical difference was observed in the frequencies of F4.The highest pitch was not significantly altered while the lowest pitch was significantly elevated[(96.8±17.7)Hz vs.(120.0±28.9)Hz,t=-3.71,P=0.001].Habitual speech volume was significantly increased[(60.0±5.2)dB vs.(63.6±9.6)dB,t=-2.12,P=0.043].Jitter,Shimmer,NHR and MPT were not obviously altered(P>0.05).Conclusions Wendler Glottoplasty could notably elevate the vocal pitch,formants frequencies and degree of vocal femininity in transgender women without affecting phonation ability and voice quality.It can be an effective treatment modality for voice feminization.

关 键 词：基频 跨性别者 音调提升 声带截短 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]