A case study of post-auricular persistent mastoid cutaneous fistula closure by anteriorly based temporalis muscle flap and tempero-mastoid fascio-cutaneous-periosteal flap


  • Rajkumari P. Khatri Dr. Rajkumari ENT and Head and Neck Oncology Centre, Indore, Madhya Pradesh, India




Mastoid-cutaneous fistula, Fistula closure, Complication of mastoidectomy, Flap, Post-aural fistula


Post-auricular cutaneous mastoid fistula (PAMCF) is a rare complication of chronic otitis media (COM), following complicate mastoid surgery and very rarely following congenital cholesteatoma. The failure rate with simple closure is high due to necrotic skin edges. Therefore several techniques for the closure of this fistula have been described. Post aural fistula after canal wall down (CWD) mastoidectomy can be successfully treated by fistula tract excision and obliterating the mastoid cavity. A 45 year old woman presented with discharging PAMCF, 10 years following radical mastoidectomy surgery. It was due to non-compliance of the patient, as she had not gone for follow up for 10 year following radical mastoidectomy. The temporo-mastoid fascio-cutaneous-periosteal advancement flap is effective for proper closure of the fistula and obliteration of the cavity by conchal cartilage along with anteriorly based vascularised pedicled temporalis muscle flap to ensure the viability of the flap and preventing the necrosis of the skin edges, henceforth the recurrence of the fistula.


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