Modified Wendler Glottoplasty: Endoscopic Bilateral Partial Cordectomy with Primary Closure

In our clinical experience we have found the modified Wendler glottoplasty to be an invaluable adjunct treatment to voice therapy in improving voice-related quality of life in transgender and gender nonconforming patients. Some believe that the modified Wendler glottoplasty, an endoscopic bilateral anterior partial cordectomy with primary endoscopic closure, both decreases the length of the membranous vocal folds by creating an anterior glottic web and increases vocal fold tension by stretching the superior mass/lip region of the vocal fold to the inferior arcuate line. In these ways, the modified Wendler glottoplasty strives to address underlying anatomic variables that alter vocal pitch including vocal fold mass and tension. Clinical studies continue to underscore the durability of this surgery for sustaining elevated pitch as well as improvement in voice-related quality of life in patients who have undergone a modified Wendler glottoplasty. In this chapter we review our preoperative and postoperative counseling and expectations as well step-by-step surgical technique to assist our colleagues in optimizing their surgical protocols to help yield optimal patient outcomes.