Chondrolaryngoplasty with Endoscopic Direct Visualization of the Vocal Cords: Demonstration of Technique

Chondrolaryngoplasty is a surgical procedure that reduces a prominent thyroid cartilage. Demand for chondrolaryngoplasty has significantly increased over recent years in transgender women and nonbinary individuals and has been shown to alleviate gender dysphoria and improve quality of life. When performing chondrolaryngoplasty, surgeons must carefully balance the desire for maximal cartilage reduction with the potential for damage to surrounding structures (ie, the vocal cords) that may result because of overaggressive or imprecise resection. Our institution has adopted the technique of direct vocal cord endoscopic visualization using a flexible laryngoscope for increased safety. Briefly, surgical steps include dissection and preparation for translaryngeal needle placement, endoscopic visualization of the needle placed above the level of the vocal cords, marking of the corresponding level, and resection of the thyroid cartilage. The following article and supplemental video provide further detailed descriptions of these surgical steps as a resource for training and technique refinement.