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Use of a sternocleidomastoid rotational and cervical-fascial advancement flap for closure of a persistent mastoid cutaneous fistula

Published online by Cambridge University Press:  10 August 2020

Y Tsitsiou ,
A Mantelakis  and
A Joshi
Y Tsitsiou
Affiliation:
Imperial School of Medicine, Imperial College Healthcare NHS Trust, London, UK
A Mantelakis*
Affiliation:
Department of Ear, Nose and Throat Surgery, Lewisham and Greenwich NHS Trust, London, UK
A Joshi
Affiliation:
Department of Ear, Nose and Throat Surgery, Lewisham and Greenwich NHS Trust, London, UK
*
Author for correspondence: Dr Angelos Mantelakis, 7 Branksea Street, London SW6 6TT, UK E-mail: aggelosmantelakis@yahoo.com
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Abstract

Background

Post-auricular mastoid fistula is a rare occurrence. It typically appears following repeated soft tissue injury, and is commonly caused by chronic suppurative otitis media and repeated surgical treatments. Management is challenging, with few reported successful surgical techniques, which often have limited applicability.

Case report

This paper presents the case of a 58-year-old male with a persistent right-sided post-auricular cutaneous mastoid fistula resulting from two previous mastoidectomies. Although the patient underwent two simple primary closures, the fistula recurred. This was successfully treated with a new technique utilising a sternocleidomastoid rotational and cervical-fascial advancement flap, which was completely healed at the one-year follow up without a recurrence of the fistula.

Conclusion

This novel technique provided definitive obliteration of a persistent cutaneous mastoid fistula. Utilising a double-layered flap and a facelift incision results in excellent functional and cosmetic outcomes.

Keywords

Cutaneous FistulaMastoidSurgical FlapMastoidectomyOtitis MediaSuppurative

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 10 , October 2020 , pp. 936 - 938
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr A Mantelakis takes responsibility for the integrity of the content of the paper

References

Luetje, CM. Postauricular mastoid cutaneous fistula: a method of closure. Otolaryngol Head Neck Surg 1980;88:90–2CrossRefGoogle ScholarPubMed
Choo, JC, Shaw, CL, Chong, YCS. Postauricular cutaneous mastoid fistula. J Laryngol Otol 2004;118:893–4CrossRefGoogle ScholarPubMed
Wadhera, 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:E33–4Google ScholarPubMed
Chew, YK, Cheong, JP, Khir, A, Brito-Mutunayagam, S, Prepageran, N. Complications of chronic suppurative otitis media: a left otogenic brain abscess and a right mastoid fistula. Ear Nose Throat J 2012;91:428–30CrossRefGoogle Scholar
Orji, FT, Ukaegbe, O, Alex-Okoro, J, Ofoegbu, VC, Okorafor, IJ. The changing epidemiological and complications profile of chronic suppurative otitis media in a developing country after two decades. Eur Arch Otorhinolaryngol 2016;273:2461–6CrossRefGoogle Scholar
Stow, NW, Gordon, DH, Eisenberg, R. Technique of temporoparietal fascia flap in ear and lateral skull base surgery. Otol Neurotol 2010;31:964–7CrossRefGoogle ScholarPubMed
Migirov, L, Carmel, E, Dagan, E, Duvdevani, S, Wolf, M. Mastoid subperiosteal abscess as a first sign of unnoticed cholesteatoma in children. Acta Paediatr 2010;99:147–9Google ScholarPubMed
Bhat, 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:E1–3Google ScholarPubMed
Gök, A, Kanlikama, M, Özsaraç, C. Congenital cholesteatoma with spontaneous epidural abscess, sinus thrombosis and cutaneous fistula. Neurosurg Rev 1996;19:189–91CrossRefGoogle ScholarPubMed
Pendolino, AL, Pavone, C, Zanoletti, E. Fibro-muscular-periosteal flap and bilobed flap for post-auricular cutaneous mastoid fistula closure. J Laryngol Otol 2019;133:723–6CrossRefGoogle ScholarPubMed
Müderris, T, Berçin, S, Sevil, E, Kırış, M. Postauricular cutaneous mastoid fistula: a case report [in Turkish]. Kulak Burun Bogaz Ihtis Derg 2013;23:288–90CrossRefGoogle Scholar
Lee, JH, Lee, PK, Rhie, JW, Ahn, ST. Treatment of postauricular mastoid cutaneous fistula by superficial temporalis fascia transposition flap. J Korean Soc Plast Reconstr Surg 2004;31:133–7Google Scholar
Vira, D, Andrews, JC. Postauricular cutaneous mastoid fistula repair. Otolaryngol Head Neck Surg 2012;147(suppl 2):218CrossRefGoogle Scholar
Asherson, N. Post-operative mastoid fistula: closure by use of temporal muscle transplant. Proc R Soc Med 1933;26:567–8Google ScholarPubMed
Olusesi, AD, Opaluwah, E. Postauricular advancement fascio-cutaneoperiosteal flap for closure of mastoid cutaneous fistula [in Polish]. Otolaryngol Pol 2014;68:276–80CrossRefGoogle Scholar
Saki, N, Araghi, S, Abshirini, H, Nikakhlagh, S. Postauricular advancement flap for closure of persistent mastoid cutaneous fistula. Biomed Pharmacol J 2015;8SE:795–7CrossRefGoogle Scholar