Expert's comment concerning grand rounds case entitled ''postoperative pharyngocutaneous fistula: treated with sternocleidomastoid flap repair and cricopharyngeus myotomy'' (by V.A. Iyoob).

Great care should be taken to minimise damage to the pharynx and upper oesophagus during an anterior approach to the cervical spine. If noticed at the time of surgery primary repair should be carried out; if noticed in the postoperative period, thorough cleaning and placement of a pharyngocutaneous drain will result in spontaneous healing of the majority of fistula. For persistent fistula secondary repair is required using well-vascularised tissue.