Hypopharyngeal or pharyngolaryngeal defects from oncological pharyngolaryngectomy result in severe functional debilitation of the areodigestive track. In contrast to esophageal reconstruction, voice reconstruction is often less readily reconstructed with less optimized voice production. Most voice reconstruction rely on external prosthetic devices, the phonation quality is often non-humanoid.
In this talk the refined method for reconstruction of cervical esophagus and voice tube will be described. The speaker’s personal experience and indications will be also discussed. The flap design, flap inset and functional outcomes of voice tube will be demonstrated.

20 patients received synchronous esophageal and voice tube reconstruction with an average age of 61. Tumour staging were IIB or above. Average follow up period was 15 months. 65% of these patients resumed full diet, 20% on soft diet, and 15% on liquid diet. The row phonation rate is 75%, and 14 patients (70%) were voice tube dependent. The average maximum phonation time was 8.9 seconds and average number of counting in a breath was 14.

With comparable deglutition outcome, J-flap provides an alternative option for synchronous esophageal and voice reconstruction. Despite the challenge, the majority of the patients achieved conversational level of phonation capacity with humanoid voice. With strict adherence to patient selection, thigh-based J-flap can be utilized safely, supporting social re-integration of these patients with their new voice.