After surgery of advanced larynx and pharynx malignancies, a main problem is reconstruction of swallowing and voice. With microvascular small bowl transplantation, we have been able to use a 30 cm segment of jejunum in a one-stage procedure to reconstruct extended defects of the oropharynx, and total by hypopharynx, as well as to create a speaking-syphon as devised by Ehrenberger. The surgical technique is described and we now report the results achieved in our first five patients. This new method enables pharyngectomized and laryngectomized patients to speak and to eat without any aspiration after about two weeks. This rapid and functionally encouraging rehabilitation means a significant improvement in a patient's quality of life and is further justification for the great effort required in using this method.