TOTAL EXCISION of the larynx is an effective and commonly performed operation for carcinoma of this region. Although the procedure is oncologically and physiologically sound, the rehabilitative, cosmetic, and psychological problems are formidable. The ability to replace the larynx following total laryngectomy would afford inestimable benefit to large numbers of people who must undergo this procedure. Three different approaches may be considered for laryngeal replacement. The first would be the development of an implantable mechanical device which would assume the functions of the larynx. A highly sophisticated device would be required to prevent the aspiration of food and liquids during swallowing, to permit free passage of air during respiration, and to produce a satisfactory voice. In addition, the patient would have to tolerate implantation of such a foreign body into one of the most heavily contaminate areas of his anatomy. A second approach would involve the utilization of local tissues