Laryngectomized patients with tracheal stomal stenosis cannot use a voice prosthesis because of possible dyspnea. We have repaired four stenotic tracheal stomas for voice prostheses. The technique of stomal reconstruction consists of insertion of a triangular skin flap to the longitudinally incised anterior wall of the trachea and laterally located Z-plasty. None of the patients had a recurrence of tracheal stomal stenosis. Three patients now use a voice prosthesis with no dyspnea. © 1989, The Society of Practical Otolaryngology. All rights reserved.