The field of tissue engineering/regenerative medicine combines the quantitative principles of engineering with the principles of the life sciences toward the goal of reconstituting structurally and functionally normal tissues and organs. There has been relatively little application of tissue engineering efforts toward the organs of speech, voice, and hearing. The present manuscript describes a study that was conducted in which a biologic scaffold derived from porcine (pig) extracellular matrix (ECM) was used to repair the defect following a hemilaryngectomy procedure in dogs. The ECM-augmented repair was compared with a control standard strap muscle (STM) procedure. The animals were sacrificed after 24 weeks at which time anatomic and histologic analyses were conducted. The ECM repair resulted in a macroscopic and microscopic reconstruction of laryngeal tissue that was superior to that observed with the STM procedure. The importance of regenerated tissue having the same structural and functional characteristics of native tissue is emphasized. A discussion of the mechanisms of ECM remodeling is presented along with the implications of such remodeling in the repair of laryngeal structures. (Contains 7 figures.)