Patients with advanced-stage hypopharyngeal or cervical esophageal carcinoma have a poor prognosis and may require a pharyngolaryngo-cervical esophagectomy. This treatment is usually palliative. In the past, the localized defect after resection has been reconstructed using many techniques. Currently, microsurgical techniques have become most common, both for full and partial circumferential defects. The jejunal free flap is the most frequently used, with free skin flaps as an alternative. The surgical complication rate is acceptable. Insufficient quantitative data exist to document postoperative swallowing function. Speech rehabilitation is often done with a tracheo-esophageal puncture technique, but studies documenting how the various methods of surgical reconstruction affect speech are lacking.