Figure 1. a, b, c. Neck skin defect and fistula occurred in the patient, who underwent esophageal stent implantation for esophageal stricture following total laryngectomy. d. The transverse cervical artery was shown by CT angiography (the white arrow). e. Design of the supraclavicular island flap. f. The flap was raised in a subfascial plane. g. The proximal skin of the flap was removed. h, i. The proximal part of flap was used for repair pharyngocutaneous fistula and the distal part of flap was used for anterior skin reconstruction. The donor site incisions were closed primarily without the need for skin grafting. j. Five months after reconstruction, the skin defect healed well and the patient can resume oral intake.