Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T06:52:55.756Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  06 June 2019

A L Pendolino*
Affiliation:
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy
C Pavone
Affiliation:
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy
E Zanoletti
Affiliation:
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy
*
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

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.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

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

References

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:E13Google Scholar
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:E334Google Scholar
3Luetje, CM. Postauricular mastoid cutaneous fistula: a method of closure. Otolaryngol Head Neck Surg 1980;88:90–2Google Scholar
4Asherson, N. Post-operative mastoid fistula: closure by use of temporalis muscle transplant. Proc R Soc Med 1933;26:567–8Google Scholar
5Choo, JC, Shaw, CL, Chong, YCS. Postauricular cutaneous mastoid fistula. J Laryngol Otol 2004;118:893–4Google Scholar
6Lee, JH, Lee, PK, Rhie, JW, Ahn, ST. Treatment of postauricular cutaneous mastoid fistula by superficial temporalis transposition flap [in Korean]. J Korean Soc Plast Reconstr Surg 2004;31:133–7Google Scholar
7Vira, D, Andrews, JC. Postauricular cutaneous mastoid fistula repair. Otolaryngol Head Neck Surg 2012;147(2 suppl):218Google Scholar
8Olusesi, AD, Opaluwah, E. Postauricular advancement fascio-cutaneo-periosteal flap for closure of mastoid cutaneous fistula. Otolaryngol Pol 2014;68:276–80Google Scholar
9Weerda, H. Ear – the auricle. In: Soutar, DS, Tiwari, R, eds. Excision and Reconstruction in Head and Neck Cancer. New York: Churchill Livingstone, 1994;223Google Scholar
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;59:1330–5Google Scholar