An anterior commissure laryngoplasty with placement of a tantalum splint has been employed to adjust vocal fold tension in nine cases. As originally described, the procedure was designed only to tighten flaccid vocal folds. The technique has been modified, however, to allow loosening of tension in tight vocal folds. All nine cases have been successful, at least to some extent, and have shown no significant complications. The details of the procedure and a general discussion of selection and management of patients are included. This procedure may provide relatively safe and effective adjustment of vocal pitch as well as strengthening the voices of patients with flaccid vocal folds.