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Fibro-muscular-periosteal flap and bilobed flap for post-auricular cutaneous mastoid fistula closure

  • A L Pendolino (a1), C Pavone (a1) and E Zanoletti (a1)

Abstract

Background

A post-auricular cutaneous mastoid fistula is a rare condition that can occur following radical mastoid surgery, chronic suppurative otitis media or spontaneous exteriorisation of cholesteatoma from the mastoid through the post-auricular skin surface. Management of a post-auricular cutaneous mastoid fistula can be challenging for the surgeon.

Objective

This paper describes a surgical refinement for post-auricular cutaneous mastoid fistula closure, involving a fibro-muscular-periosteal flap to cover the mastoid cavity, combined with a bilobed flap from the mastoid and lateral neck regions for skin closure.

Method and results

A case of a post-auricular cutaneous mastoid fistula developed after revision tympanoplasty for a cholesteatoma. The condition was successfully treated with the presented technique. Pre- and post-operative photographs are provided for demonstration.

Conclusion

The fibro-muscular-periosteal flap combined with a bilobed flap from the mastoid and lateral neck regions, in our view, can be considered a valid option for post-auricular cutaneous mastoid fistula closure.

Copyright

Corresponding author

Author for correspondence: Dr Alfonso Luca Pendolino, Dept of Neurosciences (DNS), Otolaryngology Section, University of Padova, Via Giustiniani 2, 35128 Padova, Italy E-mail: alucapendolino@gmail.com Fax: +39 049 8213113

Footnotes

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Dr A L Pendolino takes responsibility for the integrity of the content of the paper

Footnotes

References

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1Bhat, KV, Udayashankar, SG, Venkatesha, BK, Kumar, P. Bilateral atticoantral chronic suppurative otitis media presenting as bilateral cutaneous mastoid fistulas. Ear Nose Throat J 2009;88:E13
2Wadhera, R, Gulati, SP, Kalra, V, Ghai, A, Garg, A. A large postauricular cutaneous mastoid fistula caused by a cholesteatoma. Ear Nose Throat J 2010;89:E334
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8Olusesi, AD, Opaluwah, E. Postauricular advancement fascio-cutaneo-periosteal flap for closure of mastoid cutaneous fistula. Otolaryngol Pol 2014;68:276–80
9Weerda, H. Ear – the auricle. In: Soutar, DS, Tiwari, R, eds. Excision and Reconstruction in Head and Neck Cancer. New York: Churchill Livingstone, 1994;223
10D'Arpa, S, Cordova, A, Moschella, F. Further application of the bilobed flap: the split bilobed flap for reconstruction of composite posterior auricular and mastoid defects. J Plast Reconstr Aesthet Surg 2006;59:1330–5

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