[Integrity of swallowing apparatus-past, present, and future]

Swallowing is one of the most complex movement patterns. The integrity of the epithelial lining is essential.

Which surgical techniques were developed at the beginnings of modern surgery and what methods are now available to maintain/reconstitute the integrity of the swallowing apparatus?

This study comprises a selective literature search in early operation manuals and online archives, with incorporation of the authors' own experience.

Up until the 1950s, only very limited techniques were available to reconstruct the epithelial lining. Microvascular reanastomosed grafts were the game changer for reconstructive surgery, enabling reconstitution of the swallowing apparatus in primary surgery but also in challenging secondary interventions after insufficient or complicated primary therapy.

The need for anatomical and functional rehabilitation by reconstructive surgery is as pertinent as ever. Particularly in the oncological context, improved early detection and novel local treatment modalities could minimize treatment-associated damage to swallowing.