plasurВопросы реконструктивной и пластической хирургииIssues of Reconstructive and Plastic Surgery1814-1471АНО "НИИ микрохирургии"10.52581/1814-1471/88/04plasur-236Research ArticleПЛАСТИЧЕСКАЯ ХИРУРГИЯPLASTIC SURGERYСовременное состояние проблемы коррекции голоса с учетом потенциальных осложнений (обзор литературы)Current state of the problem of voice correction, taking into account potential complications (literature review)https://orcid.org/0000-0002-7165-1308СтаростинаС. В.StarostinaS. V.

Старостина Светлана Викторовна – д-р мед. наук, профессор, профессор кафедры болезней уха, горла и носа Института клинической медицины

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Svetlana V. Starostina, Dr. Med. sci., Professor, the Department of Ear, Throat and Nose Diseases, the Institute of Clinical Medicine

8-2, Trubetskaya st., Moscow, 119991,

Starostina_sv@inbox.ruhttps://orcid.org/0000-0002-5577-5810СтаценкоЯ. А.StatsenkoYa. А.

Стаценко Ярослава Александровна – клинический ординатор

117152, г. Москва, Загородное ш., д. 18а, стр. 2

Yaroslava A. Statsenko – a clinical resident

2, 18a, Zagorodnoye sh., Moscow, 117152

statsenko.y.a@mail.ruhttps://orcid.org/0000-0001-6537-0510МокоянЖ. Т.MokoyanJ. Т.

Мокоян Жанна Тиграновна – канд. мед. наук, ассистент кафедры болезней уха, горла и носа Института клинической медицины 

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Zhanna T. Mokoyan, Cand. Med. sci., Assistant Professor, the Department of Ear, Throat and Nose Diseases, the Institute ofClinical Medicine

8-2, Trubetskaya st., Moscow, 119991

god_zhan@mail.ruhttps://orcid.org/0000-0002-1257-9879СвистушкинВ. М.SvistushkinV. M.

Свистушкин Валерий Михайлович – д-р мед. наук, профессор, зав. кафедрой болезней уха горла и носа Института клинической медицины

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Valery M. Svistushkin, Dr. Med. sci., Professor, head of the Department of Ear, Throat and Nose Diseases, the Institute ofClinical Medicine

8-2, Trubetskaya st., Moscow, 119991

svvm3@yandex.ruhttps://orcid.org/0000-0002-3376-3747КарапетянЛ. С.KarapetyanL. S.

Карапетян Лиана Самвеловна – канд. мед. наук, ассистент кафедры болезней уха, горла и носа Института клиническоймедицины

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Liana S. Karapetyan, Cand. Med. sci., Assistant Professor, the Department of Ear, Throat and Nose Diseases, the Institute ofClinical Medicine

8-2, Trubetskaya st., Moscow,119991

lianaent@gmail.comhttps://orcid.org/0000-0002-6164-8594ТолдановА. В.ToldanovА. V.

Толданов Алексей Владимирович – зав. операционным блоком УКБ №1

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Alexey V. Toldanov, head of the Department the operational unit of the UKB No. 1

8-2, Trubetskaya st., Moscow, 119991

toldanov@bk.ruhttps://orcid.org/0000-0001-9195-0041ШадыевТ. Х.ToldanovТ. Kh.

Шадыев Тимур Хаитович – канд. мед. наук, доцент кафедры болезней уха, горла и носа Института клинической медицины

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Timur Kh. Shadyev, Cand. Med. sci., Associate Professor, the Department of Ear, Throat and Nose Diseases, the Institute ofClinical Medicine

8-2, Trubetskaya st., Moscow, 119991

tshadyev@yandex.ruhttps://orcid.org/0000-0003-0222-2910ИстрановА. Л.IstranovА. L.

Истранов Андрей Леонидович – д-р мед. наук, профессор кафедры онкологии, радиотерапии и реконструктивной хирургии Института клинической медицины 

119991, г. Москва, ул. Трубецкая, д. 8, стр. 2

Andrey L. Istranov – Dr. Med. sci., Professor, the Department of Oncology, Radiotherapy and Reconstructive Surgery, Institute of Clinical Medicine

8-2, Trubetskaya st., Moscow, 119991

plasticsurgeon@yandex.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical UniversityRussian FederationНаучно-исследовательский клинический институт оториноларингологии им. Л.И. Свержевского Департамента здравоохранения г. МосквыРоссияL.I. Swierzewsky Research and Clinical Institute for Otorhinolaryngology, the Department of Health of MoscowRussian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation2024300420242713750Copyright © Старостина С.В., Стаценко Я.А., Мокоян Ж.Т., Свистушкин В.М., Карапетян Л.С., Толданов А.В., Шадыев Т.Х., Истранов А.Л., 20242024Старостина С.В., Стаценко Я.А., Мокоян Ж.Т., Свистушкин В.М., Карапетян Л.С., Толданов А.В., Шадыев Т.Х., Истранов А.Л.Starostina S.V., Statsenko Y.А., Mokoyan J.Т., Svistushkin V.M., Karapetyan L.S., Toldanov А.V., Toldanov Т.K., Istranov А.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://plasur.elpub.ru/jour/article/view/236

Несоответствие звучания голоса тому полу, к которому относит себя человек, ведет к появлению у него депрессии, невозможности социализироваться и даже осуществлять профессиональную деятельность. Для решения этой проблемы предложены разные способы коррекции голосовой функции: гормональная терапия, хирургические вмешательства, фонопедическая реабилитация. Представленный обзор направлен на обобщение и систематизацию данных литературы по коррекции голоса; показаны возможности рационального подхода к ведению пациентов с несоответствием высоты голоса их полу и телосложению – как консервативными, так и хирургическими методами – с учетом потенциальных осложнений.

Цель исследования: оценить по данным литературы возможности различных методов коррекции голоса у лиц, желающих изменить его высоту, и их вероятные осложнения.

Существуют большое количество операций по повышению основного тона голоса, которые условно предполагают уменьшение длины и общей массы голосовых складок, увеличение их натяжения, которые могут проводиться, как открыто, так и эндоскопически – с помощью классического инструментария и СО2-лазера. В послеоперационном периоде нередко наблюдаются дисфония, снижение интенсивности голоса, отсутствие повышения основной его частоты и даже снижение. Помимо гранулем, необходимости ревизии при недостаточном/ассиметричном натяжении голосовых складок, возможны жизнеугрожающие осложнения в виде инфекции, отека и нарастания признаков стеноза гортани.

Гормональная терапия под наблюдением врача исключает риск осложнений, однако бесконтрольный прием тестостерона приводит к увеличению систолического артериального давления, повышению уровня гемоглобина и гематокрита и др. Наиболее характерными осложнениями при приеме эстрогенов являются значительное возрастание тромботических и сердечно-сосудистых рисков, гиперпролактинемия. Фонопедия отличается минимальным риском осложнений, она возможна как до операции и после нее для повышения основной частоты и улучшения прочих характеристик голоса.

Поиск литературы проводили в отечественных (CyberLeninka, Академия Google) и международных (PubMed) базах данных на русском и английском языках.

The discrepancy between the sound of the voice and the gender and appearance to which a person refers to himself leads to depression, the inability to socialize and carry out professional activities. To solve this problem, various ways of correcting vocal function have been proposed: hormone therapy, surgical interventions, phonopedic rehabilitation. The presented review is aimed at generalizing and systematizing the literature data on voice change, showing the possibilities of a rational approach to the management of patients with a mismatch in voice pitch to their gender and physique – both conservative and surgical methods – taking into account potential complications.

The purpose of this study is to evaluate the possibilities of various methods of voice correction in patients wishing to change the pitch of their voice, and their likely complications according to the literature.

There are a large number of operations to increase the pitch of the voice, which conditionally pursue three goals: reducing the length, total mass of the vocal folds or increasing their tension; they can be performed both openly and endoscopically – using classical instruments and a CO2 laser. In the postoperative period, dysphonia, decreased voice intensity, suture divergence, lack of increase in the fundamental frequency of the voice and even its decrease are often observed. In addition to granulomas, the need for revision with insufficient/asymmetric tension of the vocal folds, life-threatening complications in the form of infection, edema and an increase in signs of laryngeal stenosis are possible.

Hormone therapy under medical supervision eliminates the risk of complications, however, uncontrolled testosterone intake leads to an increase in systolic blood pressure, an increase in hemoglobin, hematocrit, etc. The most characteristic complications of taking estrogens are a significant increase in thrombotic and cardiovascular risks, hyperprolactinemia. Phonopedia has a minimal risk of complications, it is possible before and after surgery to increase the fundamental frequency and improve other voice characteristics.

Literature search was conducted in domestic (CyberLeninka, Google Academy) and international (PubMed) databases in Russian and English.

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The authors declare that there are no conflicts of interest present.