Endoscopic Anterior Glottic Web Formation for Voice Feminization

This video presents the endoscopic procedure of anterior glottic web formation for the purpose of voice feminization in male-to-female transsexuals, males with testicular feminization who were raised as females, and females with constitutional androphonia. The technique involves stripping the anterior one-third to one-half of both membranous vocal folds followed by suturing of the denuded vocal folds, and all steps are clearly described and illustrated in this video. Among the available surgical options for voice feminization, anterior glottic web formation affords various advantages, including endoscopic surgery without skin incision or scar, outpatient surgery, potential reversibility, and low risk for vocal fold and airway damage. One possible disadvantage is difficulty of the suturing technique, and the video will assist in overcoming this challenge. Some patients complain of inability to raise the intensity of their voice postoperatively, so it is to be borne in mind that while anterior glottic web formation is generally a successful option, additional surgery is occasionally necessary to achieve patient satisfaction.