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Sachdeva and Lanuti discuss the present status of cervical exenteration, a radical procedure utilized in the management of locally invasive cancers of the trachea, esophagus, and thyroid, as well as in recurrent tumors at the site of a tracheal stoma. Both a written review and video presentation are provided. Given the extensiveness of the dissection, resection, and subsequent reconstruction in this procedure, great care must be employed to select candidates who are the most likely to benefit. Long term outcomes of cervical exenteration have been reported to be equivalent to total laryngectomy. Anastomotic leak, tracheal stoma dehiscence, erosion of the innominate artery, and flap necrosis are all established risks, and long term survival is ultimately dependent upon the extensiveness of the underlying disease process.