Postauricular Cutaneous Mastoid Fistula Repair

Abstract

Objective: 1) To review traditional techniques for the closure of postauricular cutaneous mastoid fistulas. 2). To describe a novel double layer closure technique in the management of postauricular cutaneous mastoid fistulas. Method: Retrospective review of patients diagnosed with postauricular cutaneous mastoid fistulas in an academic medical center over a 10-year period. Results: Four patients identified from January 2000 to August 2010 were treated for postauricular cutaneous mastoid fistulas. Follow-up varied from 8 to 48 months. The etiologies of development of postauricular fistulas were all post-mastoidectomies. All patients were treated using a similar surgical technique involving double layer closure of the fistula tract utilizing 2 rotational flaps of 1) temporalis muscle and fascia and 2) conchal cartilage. All patients had successful fistula closure with lasting results. Conclusion: Cutaneous mastoid fistulas are often the result of repeated postauricular approaches for surgical treatment of mastoid infections, and can be difficult to surgically manage. These postauricular fistulas can be managed with long-term success using a novel double layer closure technique using temporalis muscle and fascia and conchal cartilage with skin.