Act of swallowing in the fixed larynx

In a 16-year-old female, complete stenosis of the larynx and hypopharynx developed as a consequence of the ingestion of lye cristals. Supraglotic laryngectomy, plastic surgery of the hypopharynx and antethoracic oesophagus were performed and the upper aero-digestive tract reconstructed. The dilated larynx remained fixed by the surrounding fibrous tissue, but the sphincteric action of the mobile vocal cords was partly salvaged. In that condition, the act of swallowing could be reestablished. The pathophysiology of this new mechanism of swallowing is discussed.