Reconstruction for severe stenosis of the hypopharynx, laryngeal inlet, and/or cervical esophagus is a challenging problem for the surgeon and his patient who want to avoid total laryngectomy. We reviewed the case records of eight patients and the relevant published literature in an effort to define the requirements for success and the causes of failure. A variety of surgical techniques were used. Seven of 8 patients eat a normal or near normal diet. Two of 4 patients, who sustained laryngeal damage at the time of initial injury, required total laryngectomy because of persistent aspiration. The 2 remaining patients and the 4 patients, who did not sustain laryngeal damage at the time of injury, speak with a good voice. Total laryngectomy should be reserved for those patient who cannot be rehabilitated following optimal reconstruction.
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