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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, LondonSW6 6TT, UK E-mail: [email protected]
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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
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

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