Tracheal autotransplantation allows for conservation laryngectomy for unilateral glottic tumors with arytenoid cartilage fixation and infraglottic tumor extension reaching the upper border of the cricoid cartilage, two major contraindications for all 'classical' conservation procedures. An extended hemilaryngectomy may be utilized for unilateral T2-T3 glottic cancers with posterior glottic extension greather than 5 mm but without extension into the ventricle. The resection can be extended towards the anterior third of the contralateral vocal fold for tumors reaching the anterior commissure (Fig. 5.36). The unilateral glottic tumor with fixation of the vocal fold is a good indication for tracheal autotransplantation. Currently, these tumors are treated with radiotherapy with or without chemotherapy with an average chance for local control of about 50 %. Surgical treatment for the recurrent or persistent tumor means total laryngectomy. This treatment policy may change when a function and organ saving surgical procedure becomes available. For unilateral glottic tumors, tracheal autotransplantation allows for a resection with margins comparable to a total laryngectomy and with a predictable good function.