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Updated: Jan 23, 2026

Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Fibro-muscular-periosteal flap and bilobed flap for post-auricular cutaneous mastoid fistula closure
A L Pendolino1, C Pavone1, E Zanoletti1
1Department of Neurosciences, Otolaryngology Section, University of Padova, Italy.
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.
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