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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)



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.


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.


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.


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: Fax: +39 049 8213113


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



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