Abstract：
OBJECTIVE: Since new evidence regarding the impact of Wendler glottoplasty (WG) on the voice in transgender women became available in the literature in recent years, we aimed to perform an updated systematic review and meta-analysis to determine the actual safety and efficacy of WG in the process of vocal feminization.
METHODS: PubMed, Embase, and Cochrane were searched for English-language articles published until July 4, 2023. Studies were found eligible if they evaluated the impact of WG on the acoustic-aerodynamic measures and quality of voice in transgender women.
RESULTS: Twenty-three studies were identified. After exclusion of three studies due to incomplete data, 20 studies including 656 patients were included in the meta-analysis. After WG, there was a significant increase of fundamental frequency, speaking fundamental frequency, and lower limit of the frequency range (p < 0.001). Concurrently, a significant reduction of frequency range and maximum phonation time was observed (p < 0.001). No significant differences were found between the pre- and postoperative values regarding the Grade, Roughness, Breathiness, Asthenia, and Strain scale score (p = 0.339). The overall score in the Trans Woman Voice Questionnaire (TWVQ) significantly improved after WG (p < 0.001).
CONCLUSIONS: WG is an effective voice feminization method in transgender women, associated with a high procedural success and low risk of postoperative complications. Significantly improved TWVQ score after surgery suggests its positive impact on the voice-related quality of life. Postoperative decrease of maximum phonation time and frequency range does not seem to significantly impact the effectiveness of voice production.
METHODS: PubMed, Embase, and Cochrane were searched for English-language articles published until July 4, 2023. Studies were found eligible if they evaluated the impact of WG on the acoustic-aerodynamic measures and quality of voice in transgender women.
RESULTS: Twenty-three studies were identified. After exclusion of three studies due to incomplete data, 20 studies including 656 patients were included in the meta-analysis. After WG, there was a significant increase of fundamental frequency, speaking fundamental frequency, and lower limit of the frequency range (p < 0.001). Concurrently, a significant reduction of frequency range and maximum phonation time was observed (p < 0.001). No significant differences were found between the pre- and postoperative values regarding the Grade, Roughness, Breathiness, Asthenia, and Strain scale score (p = 0.339). The overall score in the Trans Woman Voice Questionnaire (TWVQ) significantly improved after WG (p < 0.001).
CONCLUSIONS: WG is an effective voice feminization method in transgender women, associated with a high procedural success and low risk of postoperative complications. Significantly improved TWVQ score after surgery suggests its positive impact on the voice-related quality of life. Postoperative decrease of maximum phonation time and frequency range does not seem to significantly impact the effectiveness of voice production.
摘要：
目的：由于近年来有关Wendler声门成形术（WG）对变性女性声音影响的新证据已在文献中获得，我们旨在进行更新的系统评价和荟萃分析,以确定WG在声带女性化过程中的实际安全性和有效性.
方法：PubMed，Embase,和Cochrane被搜索到2023年7月4日之前发表的英语文章。如果研究人员评估了WG对跨性别女性的声学空气动力学措施和语音质量的影响，则研究合格。
结果：确定了23项研究。由于数据不完整，排除了三项研究后，20项研究包括656例患者纳入荟萃分析。在WG之后,基频显著增加,说到基频，和频率范围的下限（p<0.001）。同时,观察到频率范围和最大发声时间显着降低（p<0.001）。术前和术后值之间没有发现显著差异，粗糙度,呼吸,Asthenia,和应变量表评分(p=0.339)。WG后，跨性别语音问卷（TWVQ）的总分显着提高（p<0.001）。
结论：WG是跨性别女性的有效语音女性化方法，与高手术成功率和低术后并发症风险相关。术后TWVQ评分显著改善提示其对嗓音相关生活质量的积极影响。术后最大发声时间和频率范围的减少似乎不会显着影响发声的有效性。
方法：PubMed，Embase,和Cochrane被搜索到2023年7月4日之前发表的英语文章。如果研究人员评估了WG对跨性别女性的声学空气动力学措施和语音质量的影响，则研究合格。
结果：确定了23项研究。由于数据不完整，排除了三项研究后，20项研究包括656例患者纳入荟萃分析。在WG之后,基频显著增加,说到基频，和频率范围的下限（p<0.001）。同时,观察到频率范围和最大发声时间显着降低（p<0.001）。术前和术后值之间没有发现显著差异，粗糙度,呼吸,Asthenia,和应变量表评分(p=0.339)。WG后，跨性别语音问卷（TWVQ）的总分显着提高（p<0.001）。
结论：WG是跨性别女性的有效语音女性化方法，与高手术成功率和低术后并发症风险相关。术后TWVQ评分显著改善提示其对嗓音相关生活质量的积极影响。术后最大发声时间和频率范围的减少似乎不会显着影响发声的有效性。
