Laryngeal surgical treatment in transgender women: A systematic review and meta‐analysis

Schwarz, Karine; Fontanari, Anna Martha Vaitses; Schneider, Maiko Abel; Soll, Bianca Machado Borba; Silva, Dhiordan Cardoso da; Spritzer, Poli Mara; Dorfman, Maria Elza Kazumi Yamaguti; Kuhl, Gabriel; Costa, Ângelo Brandelli; Cielo, Carla Aparecida; Bôas, Anna Paula Villas; Lobato, Maria Inês Rodrigues

doi:10.1002/lary.26692

Cited by 27 publications

(27 citation statements)

References 26 publications

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“…The third approach reduces the mass and increases the stiffness of the vocal fold 7 . The reported efficacy of each approach varies, with two recent systematic reviews concluding that no one technique was definitively superior to the others 8,9 . However, a third systematic review/meta‐analysis pointed to glottic shortening procedures as producing the largest and most reliable increase in f o 10 .…”

Section: Introductionmentioning

confidence: 99%

Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization

2020

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Objectives/Hypothesis Anterior (Wendler) glottoplasty has become a popular surgery for voice feminization. However, there has been some discrepancy between its theoretical pitch‐raising potential and what is actually achievable, and downsides to shortening the glottis have not been fully explored. In addition, descriptions of the surgery are inconsistent in their treatment of the vocal ligament. This study aimed to determine 1) how fundamental frequency (fo) is expected to vary with length of anterior glottic fixation, 2) the impact of glottic shortening on sound pressure level (SPL), and 3) the effect of including the ligament in fixation. Study Design Computational simulation. Methods Voice production was simulated in a fiber‐gel finite element computational model using canonical male vocal fold geometry incorporating a three‐layer vocal fold composition (superficial lamina propria, vocal ligament, and thyroarytenoid muscle). Progressive anterior glottic fixation (0, 1/8, 2/8, 3/8, etc. up to 7/8 of membranous vocal fold length) was simulated. Outcome measures were fo, SPL, and glottal flow waveforms. Results fo increased from 110 Hz to 164 Hz when the anterior one‐half vocal fold was fixed and continued to progressively rise with further fixation. SPL progressively decreased beyond 1/8 to 1/4 fixation. Inclusion of the vocal ligament in fixation did not further increase fo. Any fixation increased aperiodicity in the acoustic signal. Conclusions The optimal length of fixation is a compromise between pitch elevation and reduction in output acoustic power. The simulation also provided a potential explanation for vocal roughness that is sometimes noted after anterior glottoplasty. Level of Evidence NA Laryngoscope, 131:1081–1087, 2021

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Section: Introductionmentioning

confidence: 99%

Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization

2020

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“…We did not find any clinical trial in the literature comparing these two techniques for SVF performed by the same group. Recently, three systematic reviews analyzed the results of different techniques; Schwarz et al concluded that no evidence exists regarding which surgical technique would be better for the vocal approach of a transgender woman; Song et al concluded that vocal folds shortening procedures appear to result in the largest increase in F 0 , as suggested in our study; and Van Damme et al concluded that all of the techniques lead to a substantial rise in postoperative F 0 , but perceptually. Primarily, laryngeal web formation seems risky for decreasing voice quality …”

Section: Discussionmentioning

confidence: 99%

“…Currently, it is not clear which SVF technique is the best. Inconsistent F 0 results increase; and duration in time, quality of life (QoL), voice quality, and self‐perceived femininity of the voice (SpFv), and so forth, have been reported …”

Section: Introductionmentioning

confidence: 99%

“…Inconsistent F 0 results increase; and duration in time, quality of life (QoL), voice quality, and selfperceived femininity of the voice (SpFv), and so forth, have been reported. [19][20][21] The aim of our study was to compare VF and QoL after two different surgical techniques in MtF Ts (CTA and GL), both performed by the same surgeons in the same population area.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of cricothyroid approximation and glottoplasty for surgical voice feminization in male‐to‐female transsexuals

Mora¹,

Cobeta

Becerra

et al. 2018

The Laryngoscope

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“…Se descartan otros 9, por hacer referencia a intervenciones médico-quirúrgicas para el tratamiento de la voz transexual (Anderson, 2014;Casado et al, 2016;Casado, Rodríguez-Parra, & Adrián, 2017;Kim, 2017;Mastronikolis, Remacle, Biagini, Kiagiadaki, & Lawson, 2013;Schwarz, Fontanari, Schneider, et al, 2017;Song & Jiang, 2017). Finalmente, se prescinde del análisis de un artículo en finés al cual no se tiene acceso y no es posible evaluar si cumple estrictamente los criterios de inclusión (Sellman & Rihkanen, 2015).…”

Section: Metodologíaunclassified

Intervención logopédica en la feminización de la voz en transexuales: revisión bibliográfica

Gómez-Raya¹

2018

RLOG

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Resumen. La transexualidad es un trastorno en el cual entran en conflicto el sexo fisiológico y el género de una persona. Las personas transexuales sienten el deseo de pertenecer al sexo con el que realmente se identifican y esto les lleva a realizar ciertas acciones para cambiar su apariencia. La mujer transexual no alcanzará la feminización de su voz mediante el tratamiento hormonal, siendo sus opciones: la cirugía de las cuerdas vocales y/o la intervención logopédica. La presente revisión bibliográfica tiene como objetivo exponer aspectos relevantes y proporcionar información amplia sobre el trabajo logopédico en el tratamiento de la feminización de la voz, en transexuales de hombre a mujer, como intervención única, no complementaria a la intervención quirúrgica. Para llevar a cabo una revisión bibliográfica descriptiva se realiza la búsqueda de artículos científicos en las fuentes secundarias PubMed y Scopus. Utilizando una metodología cualitativa, se obtiene un listado de 25 artículos, en cada una, que se acota con filtros y criterios de inclusión y exclusión, dando como resultado una lista de 7 artículos finales. En cuanto a los resultados, todos los artículos concluyen con resultados positivos de la terapia vocal en mujeres transexuales, destacando especialmente los objetivos relativos al aumento de la frecuencia fundamental y al aumento de las frecuencias formantes. En conclusión, se halla información que demuestra que la terapia logopédica puede ser eficaz en la feminización de la voz en la población transexual. Sin embargo, el escaso número de artículos impide hacer generalizaciones universales. Palabras clave: transexual; feminización; voz; logopedia.[en] Speech therapy in the feminization of voice in transsexuals: bibliographic review Abstract. Transsexualism is a disorder in which the physiological sex and the gender of a person are mismatched. Transgender people feel the desire to belong to the sex with which they actually identify and this leads them to perform certain actions to change their appearance. The transsexual woman will not achieve the feminization of her voice through the hormonal treatment, being her options: vocal cords surgery and/or speech therapy intervention. The objective of this review is to expose relevant aspects and provide wide information on speech therapy work in the treatment of the feminization of the voice in transsexuals from man to woman as a single treatment not complementary to surgical intervention. To carry out a descriptive bibliographic review, the search for scientific articles in the secondary sources PubMed and Scopus are carried out. Using a qualitative methodology, a list of 25 articles is obtained from each of them. This is checked with filters and inclusion and exclusion criteria, resulting in a list of 7 final articles. * La presente revisión ha sido llevada a cabo gracias al apoyo y tutorización de Ana Lou Moreno, logopeda y profesora en la Fundación Universitaria del Bages. 1

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Laryngeal surgical treatment in transgender women: A systematic review and meta‐analysis

Abstract: NA Laryngoscope, 127:2596-2603, 2017.

Cited by 27 publications

References 26 publications

Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization

Vocal Tradeoffs in Anterior Glottoplasty for Voice Feminization

Comparison of cricothyroid approximation and glottoplasty for surgical voice feminization in male‐to‐female transsexuals

Intervención logopédica en la feminización de la voz en transexuales: revisión bibliográfica

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