Dear Editor, We would like to thank you for your contribution to the discussion and meanwhile take the opportunity to take up a number of points: It is true that closing of injuries to the pharyngeal wall using the sternocleidomastoid muscle (SCM) via the incision, is a technically straightforward method. Nevertheless, pharyngeal defects following surgery to the cervical spine are in most cases located on the anterior part of the pharynx. Even with skilled preparation, the SCM, which must be placed between the pharynx and spine, still remains a rounded muscle bundle. The SCM therefore restricts the pharynx and can thus be an additional factor in triggering swallowing disorders. This is, in our opinion, reflected in the significantly longer period for which feeding tubes remain in place where pharyngeal defects are reconstructed using the SCM. An infrahyoid flap (IHF) is no thicker than the pharynx musculature and barely restricts the pharynx, as is shown by the CT images in our publication. In addition, the superior fascia cervicalis of the IHF, which is included when preparing the IHF, forms a sliding layer between the pharynx and spine. This sliding layer facilitates movement of the pharynx against the spine. We have discussed the necessity of this sliding layer in a previous publication [2]. It represents an additional reason for the reduction in the period for which feeding tubes remain in place. All cervical muscle flaps which are innervated by nerves, which were not damaged in the course of the spinal cord injury further curtail the patient’s already restricted motor possibilities. This applies as much to the SCM as to the IHF. Both muscles play a similar role in breathing, so that this function is equally diminished with both flaps. From the short period for which feeding tubes remained in place as per our results, it can be concluded that the IHF does not restrict swallowing. To date, it has not been possible to establish a link between swallowing disorders following injury to the cervical spine and the degree of damage to the spinal cord or the attached nerves (ansa cervicalis) [1, 3], so that the loss of the IHF on one side is clearly not a factor in the development of a swallowing disorder. In the opinion of the authors, preparation of the IHF presents no particular difficulties for the surgeon. The flap can be prepared via the incision used to access the spine and pharynx. After receiving the necessary training, an experienced surgeon will have no difficulties preparing the ansa cervicalis or the thyroid artery and vein. One of the authors is a neurosurgeon who performs the preparation alone. Should, however, technical problems arise, then interdisciplinary collaboration to the benefit of the patient should be aimed. The significantly shorter period for which feeding tubes remain in place and the associated earlier resumption of oral feeding in our opinion represent significant benefits for the patient and for this reason make the IHF the first choice in the treatment of post-operative pharyngeal defects.