Endoscopic laryngeal web formation for pitch elevation.

Endoscopic laryngeal web formation has been used to elevate the speaking voice, primarily in male to female transsexuals as part of gender reassignment intervention. The goal of this article is to review the literature regarding surgical treatment for pitch elevation and to describe a novel method of laryngeal web formation. The results of this technique are also reported in a series of six patients. All patients were assessed and treated at the St. Michael's Hospital Voice Disorders Clinic, a tertiary referral centre for voice disorders. Pre- and postoperative voice recordings, acoustic analysis, and videostroboscopic examinations were performed in this series. The acoustic data collected included isolated vowel samples, a reading task, and a modified voice range profile. The patients all underwent successful endoscopic web formation with a Gelfoam augmentation technique. The voice results collected at least 6 months after vocal fold web formation demonstrate a dramatic increase in the habitual speaking fundamental frequency. This new modification for endoscopic web formation has been shown to be a successful procedure for permanent elevation of pitch with little or no morbidity.