A one-stage repair of cervical esophagostomes can be performed using an inferiorly based sternocleidomastoid flap for inner lining and a trapezius musculocutaneous flap for the outer covering of the neck. The sternocleidomastoid muscle can provide a second layer of closure to protect the neck contents from salivary leakage. Although this muscle may be covered with a skin graft to facilitate the reconstruction, a trapezius musculocutaneous flap provides a more naturally textured covering for the neck (Fig. 223.1) (1).