Current state of the problem of voice correction, taking into account potential complications (literature review)

Abstract

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.