An unusual cause of dysphagia following total laryngectomy.

A case of dysphagia following wide-field total laryngectomy with excision of the overlying skin is presented. Initial investigation as to the cause of the dysphagia proved fruitless. Mechanical compression of an adequate-sized neopharynx by the "band-like effect" created by the skin closure was hypothesized to be the etiology of the dysphagia. Release of the scar contracture and resurfacing with a pectoralis major myocutaneous flap reestablished an adequate-sized hypopharynx and normal deglutition.